Our priorities
Europe faces three connected challenges in managing COVID as a recurring respiratory threat: low uptake, limited visibility of disease burden, and uneven system readiness.
CTI’s priorities for 2025–26 concentrate on three practical areas with the greatest potential impact: Adoption, Awareness, and Access. Together, these priorities outline where improvements are most critical to protect vulnerable populations, reinforce national programmes, and build resilient, long-term immunisation systems.
Scroll down or select a priority below to see where action can make a difference.
Workstream 1
Workstream 2
Workstream 3
Workstream 1: 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.
Prof Giovanni Rezza
Vita-Salute San Raffaele University, Milan
Prof Heidi Larson
Vaccine Confidence Project
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 2: 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.
Prof Jaime Jesús Pérez Martín
General Directorate of Public Health, Region of Murcia
Yvanie Caillé
Renaloo
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 3: Access
Objective
Foster collaboration among public health stakeholders to build resilient immunisation systems and create an environment that supports practical, lineage-level protection strategies.
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.
Prof Sir Jonathan Van-Tam
University of Nottingham (independent consultant)
Prof Roberta Siliquini
University of Torino
CTI action
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.