Country score tool to assess readiness and guide evidence generation of immunization programs in aging adults in Europe

Abstract

ObjectivesDelaying of policies for immunization of aging adults, low vaccine uptake, and the lack of supportive evidence at the national level could diminish the value in health and economics of such programs. This study aims to develop a “country score tool” to assess readiness and to facilitate evidence generation for aging adult immunization programs in Europe, and examine the comprehensiveness, relevance, acceptability, and feasibility of the tool.MethodsThe tool was developed in two phases. First, a modified Delphi process was used to construct the tool. The process included a literature review, stakeholder consultations, and a three-round Delphi study. The Delphi panel included researchers, supra-national and national decision-makers of immunization programs recruited from five countries, using snowball sampling method. The consensus was predefined at the agreement rate of 70%. Pilot testing of the tool was conducted in the Netherlands, Germany, Serbia, and Hungary involving researchers in the field of health technology assessment. After assessing the countries' readiness, researchers evaluated four features, namely comprehensiveness, relevance, acceptability, and feasibility of the tool via an online survey that included 5-scale Likert questions. The percentages of affirmative answers including “agree” and “totally agree” choices were presented.ResultsThe review identified 16 tools and frameworks that formed the first version of our tool with 14 items. Eight experts were involved in the Delphi panel. Through three Delphi rounds, four items were added, one was dropped, and all others were amended. The consensus was achieved on the tool with 17 items divided into decision-making and implementation parts. Each item has a guiding question, corresponding to explanations and rationales to inform assessment with readiness scores. Eight researchers completed the pilot testing. The tool was rated as comprehensive (75%), relevant (100%), acceptable (75%), and feasible (88%) by participants.ConclusionThrough a thorough and transparent process, a country score tool was developed helping to identify strengths, weaknesses, and evidential requirements for decision-making and implementation of immunization programs of aging adults. The tool is relevant for different European contexts and shows good comprehensiveness, acceptability, and feasibility.

Identifying factors that can be used to assess a country’s readiness to deploy a new vaccine or improve uptake of an underutilised vaccine: a scoping review

“…72 73 This theme frequently emerged across guidance documents, where there was often a focus on reaching vulnerable populations, such as children, 57 pregnant women 35 and older adults. 48 Although vaccination equity is recognised as an important aspect for consideration when deploying new vaccines or improving the uptake of underutilised vaccines, specific systems and processes for establishing equity are often not readily available. 74 While the importance of vaccination equity is well recognised, this knowledge does not necessarily translate into practical steps to ensure that people who are underserved by immunisation programmes are adequately provided for.…”

“…CONCLUSION A country's success in supporting new vaccine deployment and vaccine uptake is dependent on the country's readiness. 48 This scoping review has identified numerous guidance documents that aim to identify these factors. Of the 38 texts identified in this review, only 2 30 38 (which were focused on a specific disease (eg, influenza) or population group (eg, pregnant women), respectively) discussed all 12 overarching themes.…”