Identifying reasons for low vaccination coverage

In Sweden, most people choose to vaccinate according to the national vaccination programme and are therefore well protected against ten contagious diseases. However, in the last few years, limited outbreaks of measles and rubella have occurred after spreading from people infected abroad, highlighting that there are areas with low vaccination coverage.

The outbreaks indicate that the immunization programme does not reach all groups. Reasons for the low coverage could either be lack of access to vaccinations or that some individuals partly vaccinate their children or choose not follow the vaccination programme.

Tailoring Immunizations Programmes (TIP)

The WHO Regional Office for Europe (WHO/Europe) has developed an interdisciplinary method called Tailoring Immunizations Programmes (TIP) to identify and map barriers and facilitating factors for vaccination. The mapping of factors is then used to plan tailored interventions aiming to improve the conditions for vaccination such as to meet gaps in knowledge.

Pilot-project in 2013

The Public Health Agency of Sweden carried out a pilot study with the TIP-method in collaboration with WHO/Europe, ECDC and Karolinska Institute as well as the Department of Communicable Disease Control and Prevention and the Regional Preventive Child Health Services at the Stockholm Region.

Qualitative studies were conducted with parents, health care professionals and key informants to identify barriers and facilitating factors for vaccination against measles, mumps and rubella (MMR) as well as to gain increased knowledge regarding the groups.

The pilot focused on three identified populations with low or suspected low vaccination coverage:

The results show that there is a need for increased knowledge and understanding for the diseases and vaccinations included in the national vaccination programme among the three groups. Tailored interventions based on the results of the study and the interventions aim to increase the vaccination coverage and thus prevent spread of the diseases.

Communication and education in Rinkeby and Tensta

During 2015, communication- and education packages targeted to parents and health care professionals in Rinkeby and Tensta are included among the interventions. A group pf parents and key informants have been educated in topics related to child health, vaccinations and childhood diseases during September 2015. After the education, parents can choose to share their knowledge and answer questions from other parents in the area. Implementation is conducted in close collaboration with Child Health Services, local organizations and key informants in the area.

More information

WHO: Tailoring immunization programmes to reach underserved groups

Barriers and motivating factors to MMR vaccination in communities with low coverage in Sweden