The Challenges of Vaccine Trial Participation among Underserved and Hard-to-Reach Communities: An Internal Expert Consultation of the VACCELERATE Consortium

Authors	POULIMENEAS Dimitrios KONIORDOU Markela KOUSI Dimitra MERAKOU Christina KOPSIDAS Ioannis TSOPELA Grammatiki Christina ARGYROPOULOS Christos D THEMISTOCLEOUS Sophia C SHIAMAKKIDES George CONSTANTINOU Marinos ALEXANDROU Alexandra NOULA Evgenia NEARCHOU Andria SALMANTON-GARCÍA Jon STEWART Fiona A HERINGER Sarah ALBUS Kerstin ÁLVAREZ-BARCO Elena MACKEN Alan MARZO Romina Di LUIS Catarina VALLE-SIMÓN Paula ASKLING Helena H HELLEMANS Margot SPIVAK Orly DAVIS Ruth Joanna AZZINI Anna Maria BARTA Imre SOUČKOVÁ Lenka JANCORIENE Ligita AKOVA Murat MALLON Patrick W G OLESEN Ole F FRIAS-INIESTA Jesus DAMME Pierre van TÓTH Krisztina COHEN-KANDLI Miriam COX Rebecca Jane HUSA Petr NAUCLÉR Pontus MARQUES Laura OCHANDO Jordi TACCONELLI Evelina ZEITLINGER Markus CORNELY Oliver A PANA Zoi Dorothea ZAOUTIS Theoklis E
Year of publication	2023
Type	Article in Periodical
Magazine / Source	Vaccines
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://www.mdpi.com/2076-393X/11/12/1784
Doi	http://dx.doi.org/10.3390/vaccines11121784
Keywords	barriers; COVID-19; Europe; pandemic preparedness; SARS-CoV-2; vaccinations; vaccine education; vaccine trials
Description	Underserved and hard-to-reach population groups are under-represented in vaccine trials. Thus, we aimed to identify the challenges of vaccine trial participation of these groups in member countries of the VACCELERATE network. Seventeen National Coordinators (NC), each representing their respective country (15 European countries, Israel, and Turkey), completed an online survey. From 15 eligible groups, those that were more frequently declared underserved/hard-to-reach in vaccine research were ethnic minorities (76.5%), persons experiencing homelessness (70.6%), illegal workers and refugees (64.7%, each). When prioritization for education on vaccine trials was considered, ethnic groups, migrants, and immigrants (5/17, 29.4%) were the groups most frequently identified by the NC as top targets. The most prominent barriers in vaccine trial participation affecting all groups were low levels of health literacy, reluctance to participate in trials due to engagement level, and low levels of trust in vaccines/vaccinations. This study highlighted population groups considered underserved/hard-to-reach in countries contained within the European region, and the respective barriers these groups face when participating in clinical studies. Our findings aid with the design of tailored interventions (within—and across—countries of the European region) and with the development of strategies to overcome major barriers in phase 2 and phase 3 vaccine trial participation.