European Immunization Legislation
In the last five years, Europe has experienced outbreaks and increased incidence of vaccine-preventable diseases, notably measles, across the region. This represents a marked change, since the World Health Organization (WHO) European Region had reported an immunization coverage rate of almost 95 percent in the years 2012-2013. Since then, countries from in the region have made notable changes to frameworks for immunization legislation, which are examined in detail in Legislative Approaches to Immunization Across the European Region.
This study by Sabin is the first and only systematic review of immunization legislation that includes all 53 countries in the WHO European region and provides a comprehensive overview that can be used by countries as a point of reference when evaluating legislative frameworks for immunization laws. The research was conducted using qualitative methods, surveying the 53 countries in the European Region, and complementary desk research. Additional information was collected from authoritative secondary sources and from insights provided by national experts and members of the project steering committee. Sabin’s technical partner, the Georgetown University’s O’Neill Institute for National and Global Health Law, supported the project with in-depth legal analysis, the development of categorization criteria and classification of current country approaches. This comprehensive examination included legislation, supporting documents, national constitutions, public regulations, decrees and other relevant information on country immunization programs, which are now publicly available in Sabin’s European Immunization Policy Database.
Because approaches to immunization legislation across the European Region are diverse, a Matrix: Immunization Legislation was developed to categorize country laws and policies and provide an overview of the degree of immunization oversight. A second tool, the Likert Scale: Assessing Levels of Immunization Legislation, was developed to further classify country immunization legislation with a scale from recommended to mandatory immunization with robust monitoring and follow-up, divided into five levels. Additionally, five national and regional case studies provide further comparison and analysis of legislative approaches to immunization.
This study is part of Sabin’s strategic objective to provide evidence-based resources for policy makers to inform country decision making. Sabin serves as a broker by organizing parliamentary briefings and legislative workshops to build political will for immunization, sharing technical resources and supporting country ownership of immunization systems.
2018 CASE STUDIES
The Baltic States: A comparison of legislative approaches across three countries with similar historical, geographic and health contexts
France: Moving towards a more coercive approach to immunization
Moldova: Reviewing a recommended approach with mandatory requirements for school attendance
The Nordic countries of Denmark, Finland, Norway and Sweden: The recommended approach in practice
The Ukraine: Exploring factors that undermine a strong legislative framework for immunization
The 2017 case studies explore how Finland, Latvia, and the United Kingdom, countries with high immunization coverage levels, well-financed programs, and relevant legal frameworks, have tackled vaccine procurement, financial provisions, and provisions to increase vaccine uptake.
Other Country Laws & Regulations Related to Immunization
Sabin has gathered immunization-related laws and regulations from partner countries and other countries to serve as a tool for national policy makers interested in strengthening their immunization systems through legislation.