de Laat Cindy R, Simons Joost J M, Westra Tjalke A, Hiligsmann Mickaël
Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Market Access Department, GSK, Van Asch van Wijckstraat 55h, 3811 Amersfoort, The Netherlands.
Vaccine X. 2023 Jun 27;14:100340. doi: 10.1016/j.jvacx.2023.100340. eCollection 2023 Aug.
Immunocompromised patients (ICP) have an increased risk for infectious diseases. Vaccines could help reduce this risk. However, ICP do not always receive or are reimbursed for the specific vaccinations on which they are dependent in the Netherlands. This research aims to gain insights into the current challenges in the vaccination process of ICP in the Netherlands. Moreover, it aims to explore potential solutions for these challenges and the ideal vaccination process.
Twelve semi-structured interviews with relevant stakeholders were conducted. Partly based on the challenges found by the Council for Health and Society (RVS) and the Dutch National Health Care Institute (ZIN) an interview guide was developed.
Several newly emerged challenges were identified: fair reimbursement for the efforts of stakeholders; circular reasoning of vaccine reimbursement and guidelines; suboptimal translation from guidelines to practice and no smooth-running infrastructure. Most challenges corresponded with those stated by the RVS and ZIN. Affordability and knowledge deficit in healthcare providers and patients were the most important challenges. Rarely the same solutions were mentioned, and no ideal vaccination process emerged.
The various challenges in the vaccination process of ICP in the Netherlands implies the difficulty to solve the problem. It is recommended to focus on solving the most important challenges. A potential solution is to adjust the GVS registration process to make it easier for the pharmaceutical industry to apply for reimbursement towards various high-risk groups. Additionally, vaccination should have a more prominent role in the education of healthcare providers. Furthermore, stakeholders need to cooperate more to solve the reimbursement and guidelines issue.
免疫功能低下患者（ICP）患传染病的风险增加。疫苗有助于降低这种风险。然而，在荷兰，ICP并不总是能接种他们所依赖的特定疫苗，也无法获得这些疫苗的报销。本研究旨在深入了解荷兰ICP疫苗接种过程中当前面临的挑战。此外，它还旨在探索应对这些挑战的潜在解决方案以及理想的疫苗接种流程。
对相关利益相关者进行了12次半结构化访谈。部分基于卫生与社会理事会（RVS）和荷兰国家医疗保健研究所（ZIN）发现的挑战，制定了一份访谈指南。
确定了几个新出现的挑战：利益相关者的努力获得公平报销；疫苗报销和指南的循环推理；从指南到实践的翻译不理想以及基础设施运行不顺畅。大多数挑战与RVS和ZIN提出的挑战相符。医疗服务提供者和患者的可承受性以及知识不足是最重要的挑战。很少有人提到相同的解决方案，也没有出现理想的疫苗接种流程。
荷兰ICP疫苗接种过程中的各种挑战意味着解决该问题存在困难。建议专注于解决最重要的挑战。一个潜在的解决方案是调整GVS注册流程，使制药行业更容易向各类高风险群体申请报销。此外，疫苗接种在医疗服务提供者的教育中应发挥更突出的作用。此外，利益相关者需要更多地合作来解决报销和指南问题。
