Our priorities

Europe faces many challenges in managing COVID as a continuing respiratory threat. The CTI has prioritised three major barriers to disease prevention: limited visibility of disease burden, low vaccine uptake and aligned public health strategies.

We have separated these into key workstreams under the banners of: Adoption, Awareness, and Access. Together, these priorities outline areas where improvements have major potential to increase protection of vulnerable populations, reinforce national immunization programs, and build resilient public health positioning.

Scroll down or select a priority below to see where action can make a difference.

Awareness

Objective

Address knowledge gaps around COVID disease burden, particularly hospitalisation rates. Generate and communicate evidence to highlight the important role protein-based vaccines have to play in supporting vaccine confidence, to ultimately increase uptake, vaccine coverage rates and public protection.

COVID remains a significant driver of hospitalisations and healthcare use in Europe, but its impact is rarely fully recognised. Public and professional attention has shifted away from COVID, and in many countries routine reporting has become less visible. This makes it harder for decision-makers to gauge the true burden of disease or the populations most at risk.

At the same time, vaccination coverage rates are low and uneven across the region. Limited visibility of VCRs, together with minimal public understanding of where COVID fits within the broader landscape of respiratory threats, contributes to reduced uptake. Disinformation and lingering misconceptions about COVID and vaccines further complicate communication efforts.

COVID remains a major driver of hospitalisations and healthcare use across Europe, yet its true impact is often underestimated. Public and professional attention has shifted, and routine reporting in many countries is less visible—making it harder for decision-makers to assess disease burden or identify populations most at risk.

Meanwhile, vaccination coverage remains low and uneven across the region. Limited visibility of vaccine coverage rates (VCRs), combined with poor public understanding of COVID’s place among respiratory threats, contribute to reduced uptake. Disinformation and persistent misconceptions about COVID and vaccines further complicate communication efforts.

Raising awareness of both disease burden and coverage levels is critical to keeping programmes aligned with real-world risks—and to ensuring the public understands why COVID vaccination still matters.

CTI action

CTI will strengthen the visibility of COVID burden and vaccination coverage across key European countries, and support clearer, evidence-based communication about COVID as an ongoing public health challenge. This work will focus on making trends easier to interpret, helping stakeholders understand where gaps lie, and informing more effective seasonal communication and programme planning.

Workstream Leads

Prof. Jaime
PERÉZ MARTÍN

Regional Ministry of Health, Murcia,
Spain

Yvanie
CAILLÉ

Renaloo,
France

Adoption

Objective
Promote routine COVID vaccination strategies by understanding the gap between recommendations and actual uptake, and by addressing the behavioural and practical drivers of vaccination decisions.

Across Europe, COVID vaccination rates remain far below recommended levels, especially among older adults and people with underlying conditions. Although vaccine supply is no longer the primary barrier, the shift from emergency response to routine vaccination has exposed practical, behavioural, and organisational obstacles that limit uptake.

Many people perceive COVID risk as low, or see vaccination as unnecessary outside a pandemic context. Issues such as reactogenicity concerns, convenience, access routes, and fatigue also shape decisions. For health systems, integrating COVID vaccination into existing seasonal programmes has proven more difficult than expected.

Understanding how people make vaccination decisions – and how programmes can remove friction and increase acceptability – is essential for protecting those most at risk and strengthening Europe’s long-term immunisation approach.

CTI action

CTI will examine the key drivers of COVID vaccination decisions among both patients and healthcare professionals, and explore how seasonal COVID vaccination can be better integrated into national programmes. This work will generate insights to support evidence-based communication, improve programme design, and help decision-makers address the factors that most influence uptake.

Workstream Leads

Prof. Giovanni
REZZA

Vita-Salute San Raffaele University,
Italy

Prof. Heidi
LARSON

Vaccine Confidence Project,
Belgium

Adaptability

Objective
Continual changes in the dominance of sub-lineages and variation between geographic regions, make highly variant specific vaccine strain decisions sub-optimal. A more practical, lineage-level approach to the current annual vaccine strain selection would assist with earlier recommendations and help ensure timely reliable vaccine supply, whilst providing high-level disease protection.

As COVID continues to pose a threat to health across Europe, countries need immunisation systems that can plan and deliver vaccination in a predictable, coordinated way. Yet capacity and access remain uneven across Europe, and COVID vaccination is still not fully integrated into national immunisation infrastructures. These gaps make it harder to ensure consistent protection for older adults, immunocompromised populations, and other at-risk groups.

System fragmentation also affects the processes needed to maintain broad, lineage-level protection. Surveillance and data-sharing are variable, and strain selection timelines are not always clear or predictable. Without stronger alignment on these system elements, it becomes more difficult for multiple vaccine platforms to be available and deployable within realistic timeframes.

Building more resilient, integrated systems is essential to improving routine COVID vaccination and strengthening long-term preparedness.

CTI action

The CTI will examine practical steps to support stronger, more integrated immunisation systems, including the processes that underpin timely strain selection, surveillance, and the availability of multiple vaccine platforms. This work will bring together expert views on how to strengthen access pathways and support more sustainable, resilient COVID vaccination programmes across Europe.

Workstream Leads

Prof. Jonathan
VAN-TAM

University of Nottingham,
UK

Prof. Roberta
SILIQUINI

University of Torino,
Italy