Abstract
Rotavirus (RV) is a major agent of gastroenteritis and an important cause of child death worldwide. Immunization has been available since 2006. (1) Twelve years after the authorization of two rotavirus vaccines of demonstrated efficacy and with a strongly positive benefit-risk profile, implementation in Europe remains low. The aim of this study is to review existing barriers to access and implementation of RV vaccination in Europe. A literature search using online electronic databases was conducted to collect information on national and local recommendations, costs and perception of barriers for implementation of RV vaccination in Europe. Relevant scientific articles published between 2010 and 2018 were included in the review. Some key factors have been identified as existing barriers to vaccine access and implementation. The direct and indirect costs for vaccination and the limited perception of RV severity by the families are two major barriers for large-scale implementation of RV vaccination programs in Europe. Insufficient information and lack of public awareness on the benefits of RV vaccination may lead to negative perceptions among the general public. However, some authorities may restrict access due to the wrong perception of disease burden. Among the other identified barriers are: economic assessment of universal RV vaccination, cost-effectiveness of RV vaccination, funding of RV vaccination, and safety issues. Decentralized systems are expected to see less access and implementation of RV vaccines. Negative public perceptions on the necessity of RV vaccines could be serious barriers to access and use of RV vaccines in the studied countries. The implementation of RV vaccines is still low. Barriers to implementation vary according to settings. Nevertheless, public health authorities should promote greater public engagement and education for health-care providers on vaccination benefits in order to implement RV vaccination.
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