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

Technical report

European Centre for Disease Prevention and Control. Overview of the implementation of COVID-19 vaccination strategies and deployment plans in the EU/EEA. 21 April 2022. Stockholm: ECDC; 2022.

This report provides an updated overview of the progress with national COVID-19 vaccination strategies and deployment in European Union/European Economic Area (EU/EEA) countries, including updates on:
• overall vaccine uptake and uptake by target group;
• vaccination strategies and policies;
• challenges and good practice with the roll-out, including vaccine acceptance and uptake.

Executive summary

Vaccine COVID-19 rollout overview

  • As of 10 April 2022, over 1.2 billion vaccine doses have been administered in the EU/EEA, 328 million people have completed the primary vaccination course and over 239 million individuals have already received a further dose of vaccine in addition to the primary course (all 30 countries reporting).
  • Since the start of COVID-19 vaccine deployment in December 2020, the cumulative vaccine uptake in the total EU/EEA population has reached 72.5% (range: 29.5−86.2%) for the complete primary course and 52.8% (range: 8.8−70.6%) for an additional dose. Among adults (aged 18 years and older) the cumulative vaccine uptake reached 83.3% (range: 35.2−94.7%) for the complete primary course and 63.7% (range: 10.8-88.2%) for an additional dose (pooled data from 30 reporting countries). However, progress differs across countries, with two countries still reporting less than 50% of the total population having completed the primary vaccination course (Bulgaria and Romania).
  • The median uptake of full vaccination with a completed primary course among older adults aged 60 years and above has reached a plateau, at just above 91%. Median uptake of completed primary vaccination has reached 74.7% in 18−24 year-olds; 78.4% in 25−49 year-olds and 85.4% in 50−59 year-olds (27 countries reporting). In eligible adolescents and children the median uptake of full vaccination with a completed primary course is 23.2% in those aged under 18 years (29 countries reporting); 72% in 15−17 year-olds and 38% in 10−14 year-olds (27 countries reporting). Among older adults aged 60 years and above, the median uptake for an additional dose has already reached 82.8% (range: 13−100%; 26 countries reporting).

Vaccination strategies and policies during roll-out

  • All EU/EEA countries offer vaccination to those aged 12 years and over. A total of 28 countries are recommending vaccination to all children aged 5−11 years and two countries are recommending vaccination only for those aged 5-11 years with risk factors.
  • Twenty-two countries recommend specific COVID-19 vaccine products for particular population groups. The adaptation is mainly based on age-specific recommendations for Vaxzevria, Spikevax and COVID-19 Vaccine Janssen.
  • All 30 countries recommend an additional primary dose as an extension of the primary course for those with weakened immune systems and all countries are recommending a booster dose for different groups in the general population to improve protection in individuals whose immunity may wane after completing the primary course1. Half of the EU/EEA countries are recommending booster doses for all adults aged 18 years and over and half are recommending boosters for adolescents. A total of 13 countries are recommending boosters to all those aged 12 years and over and two countries are recommending them to all those aged 16 years and over. Seven countries have also now started recommending a second booster dose (four doses) to different vulnerable population groups, such as residents in long-term care facilities (LTCFs) and the elderly, with various age cut-offs.
  • Nineteen countries (19/24) have changed their vaccination strategies in light of the circulation of the Omicron variant of concern (VOC), with the majority of countries having reduced the interval for administration of the booster dose after completion of the primary course and enhanced risk communication initiatives.
  • In the majority of countries, vaccination is not mandatory. Six countries have mandatory vaccination in place for different population groups, in particular healthcare workers and/or workers in LTCFs, and one country is planning to make vaccination mandatory in the future.

Vaccine acceptance, hesitancy, and uptake

  • Many countries are trying to reach population groups that still have low uptake, such as underserved groups that do not have adequate access to healthcare, vulnerable groups and young people.
  • Countries are using a range of strategies to encourage vaccine acceptance and address vaccine hesitancy or increase uptake. These include measures such as mobile and pop-up vaccination teams/clinics; targeted communication strategies; outreach initiatives and intersectoral partnerships for community-based interventions. Some countries have also introduced incentives to be vaccinated and many countries require vaccination certificates in order to gain access to places/events.

The roll-out of national vaccination campaigns is an ongoing process, and this report provides a snapshot of the progress to date.

Monitor the COVID-19 vaccine roll-out