OBJECTIVES: The aim of this study is to review existing barriers to access for rotavirus vaccines (RV) in 5 European countries (EU5): Spain, Italy, France, Germany and the United Kingdom (UK).

METHODS: A structured literature search using online electronic databases was conducted to identify primary literature and national HTA recommendations guidelines. The search strategy was based on terms; rotavirus, economics and the European 5 countries: France, Germany, Italy Spain and the UK. Relevant literature published between 2007 and 2017 were included in the review.

RESULTS: Eight publications were identified and included in the review. Three key factors were identified as existing barriers to vaccine access. Firstly, national policy recommendations around how rotavirus vaccines were introduced: In Italy, rotavirus is not considered an essential vaccine and recommendations are therefore made at a regional level, resulting in variance in vaccine uptake and coverage between regions. Secondly, the national system of vaccine administration: centralized systems (such as the UK) are expected to see greater access and uptake. However, such systems may also restrict access due to the reliance on the policy-makers’ perception of disease burden. Finally, the occurrence of vaccine hesitancy (acceptability or refusal): lack of public awareness and insufficient communication on the benefits of vaccines can lead to refusals and negative perceptions from the general public. One study which conducts a confidence in immunisation survey, 41% of the French respondents considered vaccines unsafe compared to 12% of respondents in other nations.

CONCLUSIONS: Variations in vaccine recommendation systems along with potentially false perceptions on their necessity from the general public and policy makers can constitute as barriers to access and uptake of vaccines in EU5. Vaccine coverage across the EU5 may be improved by common guidelines and schedules for vaccination between countries, along with greater public engagement and improved education on vaccination benefits.