Context
Vaccination coverage is very low in Romania, compared to WHO-set targets, and is decreasing over time. For example, influenza vaccination reached 21.3% of the population in 2022, while the WHO set target is 75%. A law on mandatory vaccination drafted in 2017 (following a significant measles outbreak that occurred in Romania in 2016) was withdrawn from the parliamentary debate after facing strong opposition both at political and public levels. The only measures taken to increase the vaccination rates over the last years were to include the pharmacists among the vaccinators for influenza, and to make certain vaccines available in community pharmacies.
Impetus for the reform
The necessity for a vaccination strategy was acknowledged by the Ministry of Health as a measure to prevent possible outbreaks or re-emergence of certain communicable diseases. Further, the need for defining strategic directions in this area was driven by international requirements and initiatives, such as the Council Recommendation of 7 December 2018 on strengthened cooperation against vaccine-preventable diseases or the WHO Immunization Agenda 2030: A Global Strategy to Leave No One Behind, and by national strategic documents such as the National Health Strategy 2023–2030 and the 2030 National Strategy for the Sustainable Development of Romania.
Main purpose of the reform
The main purpose of the reform is ensuring equitable access to safe and effective vaccination services, contributing to better population health so that everyone, at any time, at any age can benefit from vaccines for their own health and well-being.
Content/characteristics of the reform
The strategy has a holistic approach intending to act on multiple directions, namely:
- ensuring the proper policy and regulatory framework to encourage vaccination uptake,
- ensuring lifelong universal access to vaccination,
- ensuring continuity in the vaccine supply and their efficient use,
- continuously improving the vaccine safety monitoring systems,
- strengthening the monitoring and evaluation of the National Vaccination Programme by analyzing the data from the national vaccination register (RENV) and the surveillance data of vaccine-preventable diseases,
- ensuring sufficient numbers of trained human resources, hence, increasing surveillance capacity for vaccine-preventable diseases,
- improving communication to increase the population's confidence in the benefits of vaccination through sustainable social partnerships, and
- enhancing the implementation of the European region vaccination policies.
Implementation steps taken (or scheduled)
The strategy has an Implementation Action Plan with specific tasks, responsible institutions, monitoring indicators, expected results, deadlines, estimated costs and a source of financing for each specific objective. For most of the tasks, the responsibility is shared among the Ministry of Health, district health authorities, specialized institutions, professional organizations and civil society. Further, institutions from the education and social sectors are involved.
Outcomes to date and any evaluation
The strategy was approved in October 2023. First steps for the implementation to be taken in 2024 would consist of legislative adjustments and additions, vaccines procurement and reserve stocks procedures, updated methodologies for the surveillance of postvaccination adverse reactions and quality assurance of the National Electronic Vaccination Registry data.