OBJECTIVES: Quick and equitable vaccine access is a global priority. However, the vaccine assessment is complex, meaning there is variation in vaccine schedules between countries and limited opportunities to develop a centralized framework. This heterogeneity further contributes to inequity of vaccine access. This work aims to increase awareness of the key vaccine assessment elements in EU and non-EU countries.

METHODS: Pragmatic desk-based research was conducted in June 2024 to explore the key stages involved in vaccine market access and how these differ across England, Italy, Germany, France and the United States (US). Where available, data were extracted about the stakeholders involved in vaccine appraisal, the key assessment factors and value framework considered, and the number and type of vaccines included in the national vaccination schedule.

RESULTS: National Immunization Technical Advisory Groups (NITAGs) are key stakeholders in all five countries but play different roles. In some countries the NITAG is solely responsible for vaccine appraisal (England, Germany, US), but in other countries the vaccine appraisal is conducted by the health technology assessment (HTA) body (Italy) or both the NITAG and HTA body in parallel (France). There are key differences in the vaccine assessment by NITAGs and HTA bodies. For example, NITAGs consider public health impact, which is not considered by HTA bodies. There are also differences in the value framework between NITAGs in different countries. For example, only England’s NITAG formally considers the disease impact on quality of life of carers. Consequently, the key vaccine assessment factors differ between countries, resulting in a different number of vaccines in each country’s vaccination schedule.

CONCLUSIONS: Several between-country differences in vaccine market access are identified; for example, the role of NITAGs, vaccine assessment factors, and value frameworks. Vaccine developers should consider these results when planning market access strategies to ensure rapid and equitable vaccine access across countries.