Study reveals big regional differences in vaccination coverage

An analysis from Belgian independent health insurance fund Helan has found that vaccination rates are significantly lower in Brussels and Wallonia than in Flanders, and attributes this to administrative fragmentation in the two lagging regions.

This fragmentation leads to reduced access to vaccines and vaccine hesitancy among the population. Figures also show that the vaccination rate amongst adults, in particular, remains too low.

Helan is therefore calling for an executive cooperation agreement to streamline vaccination policy in the country.

An analysis of its members’ data shows that in Flanders, 58.5% of people aged 65 and over have been vaccinated against flu, compared with 43.3% in Brussels and 44.7% in Wallonia. The World Health Organisation (WHO) recommends a vaccination rate of 75% as a target.

According to figures from Sciensano, the flu vaccination rate in Brussels is rising, but this is not the case in Wallonia.

The vaccination rate for pneumococcal disease remains low across the country. In 2023–2024, only 14% of the at-risk population - people aged 65 and over and those aged 45 and over with a chronic illness - had been vaccinated.

In Flanders, all matters relating to vaccination are centralised within the region's health department, but in Wallonia the situation is more complex.

Vaccination of children and pregnant women in the French Community is managed by ONE (Office de la naissance et de l’enfance), but the public bodies Vivalis (in Brussels) and AViQ (in Wallonia), which operate at regional level, are responsible for vaccination policy for adults.

For adults, there are currently no targets in Wallonia and Brussels to achieve a specific vaccination coverage rate.

Vaccination schedules and registration systems also differ between the federated entities. In Flanders, Vaccinnet is used and has been recording all vaccinations since 2006.

In the French-speaking part of the country, two registration systems are used: ONE uses E-vax to record the vaccinations of children and pregnant women. Vivalis and AViQ, on the other hand, use Vaccicard for recording vaccinations in adults, a system which has only recently been launched. E-vax and Vaccicard are not yet linked.

According to Helan’s study, the fragmentation of vaccination policy has an impact on the accessibility of vaccines and vaccine hesitancy. Certain vaccines are less accessible in one region than in another.

The differences between the basic vaccination schedules also make it difficult for members of the public to understand why they vary from region to region. The effectiveness of the system is also limited because vaccination rates are not monitored sufficiently.

A high vaccination coverage rate among the population is essential to protect as many people as possible against diseases and to prevent outbreaks.

Studies also demonstrate the economic benefits of a high vaccination coverage rate. Every €1 invested in vaccination yields an average return of €19, whilst the lifetime cost of vaccination remains relatively low.