How are vaccines introduced into the national vaccination programme?

The National Institute for Health and Welfare constantly evaluates the needs for developing the national vaccination programme. When considering introducing a new vaccine into Finland's national vaccination programme, the vaccine and the vaccination programme are evaluated based on scientific evidence from the perspective of both individuals and society.

The National Advisory Committee on Vaccines (KRAR) has determined four conditions which a vaccine available for the entire age group should meet:

• vaccination should result in a reduction in diseases with significance to public health
• the vaccine must be safe for individuals
• the extensive use of the vaccine is not expected to cause excessive harm at the population level compared with its benefits
• the needed financial investment should be reasonable in relation to the health benefit gained.

The evaluation work takes place at specialist working groups discussing specific vaccines at the Finnish Institute for Health and Welfare. The need for establishing a vaccination-specific specialist working group is assessed, for instance, if a new vaccination is introduced to the market or if there is a change in the incidence of a disease preventable with a vaccine.

There is an aim to always include representatives of national specialist groups relevant to the discussed disease and vaccine in the evaluation groups. A recommendation provided by the working group in its final report includes a justified statement of whether the vaccine should be included in the national vaccination programme. The vaccine can be targeted an age group as a whole or, for example, those belonging to a specific risk group.

After discussing the recommendation by the expert working group, KRAR will prepare its own recommendation. The recommendation of the Finnish Institute for Health and Welfare is based on these processes.

The Ministry of Social Affairs and Health makes the decision on the introduction of the vaccine to the national vaccination programme after consulting with the Advisory Board on Communicable Diseases (TTNK). The Parliament of Finland decides on the funding of the national vaccination programme.

The process from the beginning of the evaluation work until the inclusion of a vaccine in the national vaccination programme takes at least 2.5 years.