Improving the Vaccine Decision-Making and Evaluation Framework: critical to accelerate citizen access and increase trust in vaccination throughout Europe

2014 11 28 Written by Vaccines Europe

Vaccines Europe is pleased to announce the publication in Vaccine of a cross-country comparative study analysing National Immunisation Technical Advisory Groups policies and practices.

This work comes at a crucial time in Europe where decision-making processes to include vaccines in national immunisation programmes is evolving as to optimise and facilitate timely and equitable populations’ access to innovative vaccines. The more and more, governments are opening multi-stakeholder debates including public health bodies, HTA agencies, budget-holders and industry to achieve effective decision-making and implementation of vaccination programmes.

National Immunisation Technical Advisory Groups (NITAGs) play a fundamental role in national decision-making concerning the introduction and use of vaccination, and are responsible for providing government authorities with advice concerning best vaccination strategies through the issuance of so called ‘recommendations’. This step, which is specific to the vaccine decision-making process, explains most of the delay between EU marketing authorisation and effective citizens’ ability to access and benefit from newly marketed vaccines in Europe, and it is shown to be around 6.4 years (Blank P. et al. Vaccine 2013).

Using a pre-established decision analysis framework, the published study looks at NITAG practices in 13 countries (10 European, US, Canada and Australia) based on publicly available information. The study sheds light on findings corroborating previous research outcomes on the fact that NITAG processes are heterogeneous and disparate across countries, possibly explaining the disparity in access to vaccinations and immunisation programmes throughout Europe and beyond. It suggests the importance of establishing more structured, well-informed and transparent guidance that could streamline and strengthen evaluation processes, as well as decision analysis frameworks. The international expert panel involved in the study underlined the importance of vaccines from a public health perspective and the need to provide more information and better reporting on NITAG appraisals to the general public in order to contribute to enhanced credibility and trust in vaccines.

It is thought that this would ultimately benefit not only the evaluation of vaccines and vaccination strategies per se, but also indirectly increase confidence in the soundness, transparency and expertise input in vaccine decision-making, particularly at time of worrying decline in public support for this crucial public health intervention measure.

Vaccines Europe particularly welcomes earlier and better coordination of different stakeholders involved in vaccine assessment, including NITAGs, HTA bodies, public health authorities, industry and citizens within and among EU Member States. Besides avoiding duplication and fostering proper evidence-based policy decisions, this would promote timeliness and equity in access to life-saving vaccines.


The full study article and editorial can be accessed on directly on the journal’s website and are available open access. The study has been conducted through funds provided by Vaccines Europe. 

For more information on timelines of citizen access to vaccines, check out our infographic and visit this section of our website.

For more information on NITAGs, their work and role in shaping immunisation policies, we invite you to visit the WHO resource page on National Advisory Committees for Immunisation, which is accessible from here