WHO works with countries to resolve immunization inequities by embedding equity into the heart of immunization programmes. Immunization inequities are avoidable differences in immunization coverage between individuals and groups within a population.

Simply making vaccines available to everyone is not sufficient to achieve equitable uptake; tailored services may be needed to reach some communities or individuals, often including those at higher risk of infections and severe outcomes. Despite overall high coverage at the level of the WHO European Region, over 500 000 children in the Region still miss one or more recommended vaccinations each year.

Embedding equity into immunization programmes means developing processes to continuously:

• identify who has not been vaccinated according to the national routine immunization schedule;
• understand why they were left behind by identifying the barriers they face in accessing immunization programmes;
• decide how to intervene to resolve or avoid this; and
• determine if these interventions make a difference (and are sustainable).

This requires that all levels of the immunization programme understand the importance of equity and take action – from immunizers and other health-care providers on the ground to those developing policy at the national level. Addressing immunization inequities may also involve adapting policy and procedures at national, regional or local levels and allocating additional resources to support interventions.

WHO supports its Member States in all phases of strengthening equity in immunization, including:

• detecting and tracking inequities through surveillance;
• conducting research to understand the reasons individuals and populations are under-vaccinated;
• developing and monitoring the effectiveness of tailored, multi-component interventions to resolve immunization inequities; and
• providing recommendations and guidelines, such as a practical guide to identifying, addressing and tracking inequities in immunization.