Vaccination coverage trends in European Union from 1980 to 2020: A joinpoint Regression Analysis

Vaccination coverage trends across European Union (EU) countries have shown concerning variations in recent years. This study aims to analyze vaccination coverage trends for seven key vaccinations across all EU member states from 1980 to 2020. Data from the WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) dataset were analyzed using joinpoint regression models to identify significant changes in vaccination coverage trends. Seven vaccination indicators were examined: DTP-3, HEPB-3, HIB-3, MCV-1, PCV-3, POL-3, and RCV-1. Trends were categorized as positive or negative and significant or not significant, based on Annual Percent Change (APC) calculations. Analysis of 180 joinpoint regressions revealed a predominantly downward trend in vaccination coverage across the EU. 51.7% showed negative performance, while only 37.8% showed positive performance. Only 8 countries (29.6%) demonstrated increased coverage in at least four indicators, while 14 countries (51.8%) showed reduced coverage. The study reveals a concerning decline in vaccination coverage across most EU countries. The findings suggest that mandatory vaccination policies may contribute to maintaining higher coverage rates, though multiple factors influence vaccination uptake, including political, social, and educational determinants.