Vaccinations - overview

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All vaccinations are optional in Iceland.

The most significant impact on society can be obtained if many people accept general vaccination. For most general vaccinations, there is a threshold for adequate participation. For some vaccines, the thresholds are well defined and verified that there is a risk of outbreaks if they are not achieved in the community (e.g. measles). In contrast, for others, they are based on tradition (diphtheria) or mathematical models (HPV). If participation is below the threshold, it is essential to analyse the reasons and try to respond in a targeted way, e.g. with a vaccination campaign and promoting information on vaccinations in general or to specific groups, e.g. certain language groups. The Chief Epidemiologist monitors the participation in general vaccinations annually, while real-time monitoring of childhood vaccinations and school vaccinations is the responsibility of primary healthcare.

Registration of vaccinations

All vaccinations in Iceland must be registered in the Vaccination Register, which the Chief Epidemiologist supervises. In addition, it is recommended that essential vaccinations carried out abroad are registered, e.g. general vaccinations when a child moves between countries, or if revaccination is recommended, e.g. COVID-19 vaccination. Correct registration is a prerequisite to evaluate the likelihood of an outbreak spreading infectious diseases to Iceland.

Rejection of vaccination

Rejections of general childhood vaccinations are recorded in the vaccination register. It must be possible to monitor rejection development and respond if the frequency increases. The right to vaccination remains even if it is rejected. A child may receive vaccinations that the guardians refuse when they reach the age to make independent decisions about their health (16 years, according to Patients' Rights Act, No 74/1997, section IV article 25-26).

Vaccinations of high-risk groups

Participation in vaccinations of high-risk groups could be better in Iceland. Still, its monitoring is limited as information on most risk factors is unavailable to the Chief Epidemiologist. The supply of vaccines for at-risk groups the Chief Epidemiologist does not have contracts for is unsafe.  Both availability and price clearly influence the participation of high-risk groups in vaccinations recommended to reduce harm from diseases that have a higher incidence or carry an increased risk of serious illness for high-risk groups. It is essential to strengthen monitoring of the participation of risk groups in influenza, pneumonia, and pertussis vaccinations. Still, without further analysis of recipients, planning systematically to increase participation is impossible.