National Immunization Technical Advisory Groups maturity and RSV vaccination policies in Europe

Background

National Immunization Technical Advisory Groups (NITAGs) are entrusted to collect and summarize evidence to support the implementation of vaccination policies and strategies at country level. The recent (2023/2024) authorization of vaccines against the Respiratory syncytial virus (RSV) offers a case study to explore the role of NITAG in their introduction.

Methods

We conducted a comparative study of NITAG maturity and RSV vaccination implementation in older adults across EU Member States and the UK. For addressing NITAG maturity we used the WHO Joint Reporting Form data, and we considered the six WHO defined indicators, namely existence of a NITAG, formal mandate, legal basis, multidisciplinary expertise, pre-meeting document circulation, and conflict of interest disclosure. Data on RSV vaccination recommendations and implementation were collected from the Global NITAG Network, ECDC, and national institutional sources. Descriptive analyses were used to explore NITAG maturity and its relationship with the implementation of RSV vaccination.

Results

In 2024, the NITAG of 24/28 countries (85.7%) met all six WHO criteria. NITAG recommendations on RSV were identified in 12 countries (42.8%), whereas RSV vaccination was included in national immunization programmes in 10 countries (35.7%), between 2024 and 2025. Policies differ across countries in target populations (age thresholds 60–75 years), use of risk-based criteria and timing of implementation. Albeit the most of counties have reached a high level of maturity of their NITAG, a lack of publicly available recommendations on RSV was found and discrepancies were observed between NITAG recommendations and vaccination implementation.

Conclusions

Considering RSV case study, it emerges that high NITAG maturity does not necessarily translate into consistent vaccination policies across Europe. This highlights the need for stronger commitment and coordination to improve equity and timeliness in vaccines access.

Key messages

• High structural maturity of NITAGs across Europe doesn’t guarantee consistent or timely implementation of RSV vaccination policies.

• Greater commitment and coordination are needed to improve equity in vaccine access across European countries.