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email: secretariat@ineip.org
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Vaccination Equity
Vaccination Equity:
Reaching every child, every community.
Safe and effective vaccines exist, yet significant inequities in vaccination uptake and protection persist across populations and settings. Children and families experiencing poverty, social exclusion and limited access to services are consistently missed by the systems meant to protect them, with consequences that extend across the life course. How can we work together to close these gaps and ensure every child, every community, is protected?
Understanding Barriers
Why Vaccination Inequities Persist in Europe
Vaccination inequity is too often framed as a matter of individual choice or "vaccine hesitancy." Yet, the evidence is clear: inequities are predictable, patterned, and preventable outcomes of how health systems are designed, measured, and experienced. Families are not failing to vaccinate; in many cases, systems are failing families.
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Data Blind Spots
Aggregate national coverage figures mask deep inequalities between socioeconomic groups and geographies. Systems may appear to perform well while clusters of under-immunization and vulnerability remain hidden, leaving underserved communities at increased risk of vaccine-preventable diseases.
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Structural and Socioeconomic Barriers
Poverty, housing instability, inflexible clinic hours, and complex appointment systems, all create barriers to vaccination, even when vaccines are free. Access also depends on whether immunization services are convenient, accessible, and designed to meet the realities of people's daily lives.
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Trust Rooted in Lived Experience
Mistrust in vaccination often reflects a broader mistrust in institutions rather than vaccines themselves. When health services are inconsistent, inaccessible, or fail to meet people's needs, scepticism can become a rational response shaped by lived experience rather than a lack of information.
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Community Decision-Making
Vaccination decisions are shaped by shared values, social relationships, cultural norms and moral frameworks rather than by individual knowledge alone. Effective immunization programs must engage with the ways communities build trust, exchange information, and make health decisions within their social contexts.
Immunization and Vaccination Equity
LifeCourse Prevention Initiative Report
This meeting report from the 2025 LifeCourse Prevention Summit examines why vaccination inequities persist despite safe, effective vaccines and sets out an evidence-based framework for action.
2026 ReportEquity Gap
From Evidence to Action
The Summit produced a set of shared commitments that form the basis of an action-oriented agenda:
Core Objective
Make equity a core performance objective across vaccination policy, delivery, and accountability frameworks.
Better Data
Use disaggregated, equity-sensitive indicators to reveal disparities hidden within national averages.
Equity by Design
Embed equity into new vaccination programmes from the outset, so systems don't reproduce structural gaps.
Remove Barriers
Address structural barriers to access: free vaccines do not guarantee equitable reach.
Rebuild Trust
Strengthen confidence through transparency, competence, and responsive service, reinforced by clear communication.
Community Partnership
Embed community engagement and co-design as core infrastructure, and strengthen coordination across the vaccination ecosystem.
Resources
Insights, Reports & Expert Perspectives
Explore a collection of policy briefings, expert interviews, reports and newsletters from the LifeCourse Prevention Initiative.
Community Engagement Approaches to Improve Health
Community engagement approaches to improving health, the key barriers to successful engagement and a framework for building trust and equity in underserved communities.
December 5, 2025
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Barriers to Childhood Vaccination in Underserved Communities
The structural and behavioral barriers to vaccination in underserved communities and how health systems must be redesigned around people's lived realities.
December 5, 2025
Social Inequities in Child Health and Vaccine Uptake - Evidence from the UK
Evidence on the widening inequalities in childhood vaccination uptake in the UK, linking the declining coverage to rising child poverty and cuts to preventive services.
December 5, 2025
Inequalities in RSV - Lessons from Barnardo's Public Health Campaign
Barnardo's RSV public health campaign, showing how a culturally competent, community-led approach can reach underserved families and reduce health inequalities.
December 5, 2025
Overcoming System-Level Failures in Vaccination Equity
The three systemic failures that prevent vaccination programs from achieving equity, what overcoming them requires.
December 5, 2025
HTAi for Vaccines - Why It Matters and What Europe Must Get Right
What Health Technology Assessment means for vaccines, and why getting it right matters for new vaccines to reach patients equitably and efficiently across EU.
December 4, 2025
Pediatric RSV Immunisation from Across Europe and Beyond
Review of the available strategies for pediatric RSV prevention, presenting real-world evidence from across Europe and arguing that all infants need protection.
May 12, 2025
Vaccine Trust and Confidence in the Context of Inequality
The drivers of vaccine hesitancy and declining confidence globally, evidence on the role of trust, and institutional credibility in shaping vaccination decisions.
May 12, 2025
A Life Course Approach to Increase Coverage Amongst the Most Vulnerable
Strategies to improve immunization access in underserved communities, addressing social determinants of health and healthcare system barriers.
November 29, 2024
Interview: Trust Poverty and the System
Sir Terence Stephenson, Nuffield Professor of Child Health and Chair of EiP2026, offers both a systemic diagnosis and a clear prescription: there is no magic bullet — vaccination equity is the product of a more equal society, better systems, and professionals who listen before they speak.
December 4, 2025
Interview: The Power of Trusted Communities
Rukshana Kapasi, Director of Health at Barnardo's, sets out a clear reality: closing the vaccination gap requires more than clinical delivery. It requires trust — and community-based organizations are essential to building it.
December 4, 2025
Interview: The Unseen Children
Monica Lakhanpaul, Professor of Integrated Community Child Health at UCL GOS Institute of Child Health, shines a light on children who are mobile, marginalized, and invisible to the health system — and what it takes to reach them.
December 4, 2025
Interview: Child Poverty & Vaccination Inequalities
David Taylor-Robinson, Professor of Public Health and Policy at the University of Liverpool, presents stark data: the more deprived the area, the lower the vaccination uptake — and the gap is widening.
December 4, 2025
Interview: Community Engagement & Vaccination Uptake
Angela Harden, Professor of Community and Family Health, makes the case that community engagement is not the 'nice to have' of public health — it is the essential. Vaccination confidence can't be lectured into communities. It has to be built from within them.
December 4, 2025
Vaccination Equity Report 2025
The report brings together evidence, policy perspectives, and practical experience from leading experts across public health, clinical practice, social science, civil society, and policy, all focused on a critical question: why do vaccination inequities persist, and what will it take to fix them? The answer that emerged is clear: Vaccination inequities are not accidents. They are predictable, patterned, and preventable outcomes of how systems are designed, measured, and experienced.
May 1, 2026
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Vaccination Equity Report 2024
This report presents findings from a survey of 198 pediatric healthcare professionals that examines why children go unvaccinated in mixed-income communities. It distinguishes outright vaccination refusal driven by mistrust, sociocultural beliefs, and low health literacy from adherence issues such as missed appointments, which stem from logistical and economic barriers. The report closes with targeted recommendations for healthcare systems and practices to improve equity.
Volume V - Vaccination Equity - Equitable Access Requires Far More Than Free Vaccines
Free vaccines don't guarantee equal access. Why child poverty drives vaccination inequity, and why reducing it is a prerequisite.
June 8, 2026
Volume III - Vaccination Equity - Vaccination Programs Should Be Designed Around Families - Not Systems
When communities are engaged as partners, vaccination programs work better. Insights from the 2025 LifeCourse Summit on co-design, engagement, and equity.
May 21, 2026
Volume I - Vaccination Equity - When Communities Don’t Trust Vaccination Systems, It’s a System Failure
Why do vaccination systems fail the communities they serve? Insights from the 2025 LifeCourse Prevention Summit on trust, access, and the case for system change
May 7, 2026