Overview of the implementation of COVID-19 vaccination strategies and deployment plans in the EU/EEA

Technical report
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European Centre for Disease Prevention and Control. Overview of the implementation of COVID-19 vaccination strategies and deployment plans in the EU/EEA – 14 June 2021. ECDC: Stockholm; 2021.

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This report provides an updated overview of the progress of national COVID-19 vaccination strategies in EU/EEA countries, including updates on: vaccine uptake overall and by target group; current vaccination phases and priority groups, as well as any adjustments made to priority groups during the rollout; vaccination strategies and policies in place; and the use of vaccination certificates and challenges countries face with the rollout and good practices to mitigate these challenges.

Executive summary

Key messages

This report provides an updated overview of the progress of national COVID-19 vaccination strategies in EU/EEA countries, including updates on:

  • overall vaccine uptake and uptake by target group;
  • current vaccination phases and priority groups, including adjustments made to priority groups during the rollout;
  • vaccination strategies and policies;
  • the use of vaccination certificates;
  • vaccine acceptance and hesitancy; and
  • challenges and good practice with the rollout.

Vaccine COVID-19 rollout overview

  • As of 11 June 2021, a total of 333 678 903 COVID-19 vaccine doses have been distributed by manufacturers to European Union/European Economic Area (EU/EEA) countries, including over 39 million in the last week. Comirnaty (BNT162b2), developed by BioNTech/Pfizer, represents 67.3% of all doses distributed to EU/EEA countries via the European Commission’s Vaccine Strategy, followed by Vaxzevria (AZD1222), previously called COVID-19 Vaccine AstraZeneca (19.5%), COVID-19 Vaccine Moderna (9.6%), and COVID-19 Vaccine Janssen (3.3%).
  • A total of 284 124 689 vaccine doses have been administered in the EU/EEA, including over 25 million in the last week. Based on data available from 29 countries, 85% of the doses distributed in the EU/EEA since the beginning of the rollout have been administered.
  • Since the start of COVID-19 vaccine deployment in the EU/EEA in December 2020, the cumulative vaccine uptake in the adult population (aged 18 years and older) in the EU/EEA has progressed, reaching 51.2% for at least one vaccine dose (range: 14.9-67.7%) and 26.8% for the full vaccination course (range: 11.8-55.1%) (30 reporting countries).
  • Cumulative vaccine uptake is higher in those target groups that have been prioritised since the beginning of the vaccine rollout, in particular the elderly and healthcare workers (HCW).
  • In people aged 80 years and above, the median vaccine uptake was 80.7% (range: 14.6-100%) for at least one dose, and 71.6% (range: 10.4-100%) for the full vaccination course (26 countries reporting). Ten countries have administered the full vaccination course to more than 80% of the population aged 80 years and above.
  • In HCW, the median vaccine uptake was 83.9% (range: 21.4–100%) for at least one dose, and 69.9% (range: 20–100%) for the full vaccination course (17 countries reporting). Ten countries have administered at least one vaccine dose to more than 80% of healthcare workers.

Priority groups defined for vaccination

  • Vaccinations continue to be rolled out in phases through various priority groups. As of 31 May 2021, one country is still in the first phase, while 21 countries have progressed to groups in subsequent phases (of 22 countries that responded to this question).

  • Countries have primarily prioritised elderly people, residents and personnel of long-term care facilities (LTCFs), healthcare workers, social care personnel, and people with certain comorbidities. Countries are currently continuing vaccination of these groups, progressing to vaccination of younger age groups and essential workers critical to societal infrastructure. Ten countries have already opened up vaccination to any adult individual irrespective of age, underlying condition, or priority group.
  • Fifteen countries have already fully vaccinated at least one priority group, such as healthcare workers, residents and/or personnel in LTCFs, elderly people (with various lower age cut-offs across countries) or adults with co-morbidities.
  • Eighteen countries have further adapted the prioritised groups to be vaccinated, including additional age groups, healthcare workers in different settings, educational workers, and other groups with high risk of severe disease.

Vaccination strategies and policies during rollout

  • Sixteen countries have extended the timing between vaccine doses to provide the first dose to as many people in the priority groups as possible. The timing between the first and second dose varies by country and by vaccine product.
  • For individuals previously infected with SARS-CoV-2, eleven countries currently recommend only one dose (for vaccines that have a two-dose schedule).
  • Seventeen countries recommend specific COVID-19 vaccine products for specific population groups.
  • Most countries have adapted their vaccination guidelines following the report of the very rare side effects of thromboembolic events associated with thrombocytopenia following vaccination with Vaxzevria and COVID-19 Vaccine Janssen. The adaptation is mainly based on age specific recommendations for both the Vaxzeria and COVID-19 Vaccine Janssen.
  • A minority of countries (n=4) reported that they have adapted their COVID-19 vaccination strategy due to the circulation of new variants of concern. Adjustments included providing more vaccine doses to areas of high incidence of COVID-19 in general or due to high incidence of variants of concern or a redefinition of the priority groups based on the epidemiological situation. No further adjustment has been made compared to the previous report.
  • Fourteen responding countries answered that they do offer vaccination to certain individuals/ target groups who live outside of the country (e.g. transnational workers, with certain criteria such as working in LTCF, health facilities or essential workers).
  • All responding countries answered that vaccination will be accessible to any EU citizens in the country, but there may be certain conditions.
  • Five countries are planning to expand vaccination to all adolescents and in 14 countries the vaccination of children under the age of 12 years is currently under discussion and decisions will be made at a later time if the European Medicines Agency authorises any COVID-19 vaccines for that age group.

Vaccination certificates

The majority of responding countries are planning to issue COVID-19 vaccination certificates, and many have started discussions regarding the possible use of these certificates in the future, for example for travel, tourism, the easing of non-pharmaceutical interventions, or access to specific places/events.

Vaccine acceptance and hesitancy

Eleven countries have observed an increase in vaccine hesitancy mostly in relation to lower acceptance of the Vaxzevria vaccine.

Challenges and good practices

  • The majority of countries (15/23, 65%) reported that limited vaccine supply is the main challenge they face with the rollout of vaccines.

  • Some countries shared lessons learned so far in the vaccination rollout, such as establishing mass vaccination centres in cooperation with municipalities to ensure faster and effective vaccine rollout, using and optimising waiting lists for reduced wastage of doses, and using pedagogical communication.
  • Countries provided information about different measures taken to reach those who are under-served or vulnerable in the population, such as using the single dose vaccine or mobile vaccination teams.
  • As countries continue with the rollout of their national vaccination campaigns, strategies and plans will continue to be adapted. This is a rapidly moving process, and this report provides a snapshot of the progress to date.

Monitor the COVID-19 vaccine roll-out

COVID-19 Vaccine rollout overview

This report provides an overview of the progress in the rollout of COVID-19 vaccines in adults (aged 18 years and above) across EU/EEA countries.

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