Vaccination in Estonia
In Estonia, people are vaccinated according to the national immunisation schedule, and decisions about it made by the Ministry of Social Affairs. The Ministry is advised in the decision making by an expert committee on immune prophylaxis, consisting of the representatives of the Ministry of Social Affairs, the Health Board, the State Agency of Medicines, the Estonian Health Insurance Fund, the Estonian Association of Family Doctors, the Estonian Society of Infectious Diseases, the Estonian Paediatric Association, the Estonian Union for Child Welfare, the Estonian Nurses Union, the Estonian Midwives Association, and the Estonian Society for Immunology and Allergology.
The state creates an opportunity
According to the agreed upon schedule, the Health Insurance Fund (the Ministry of Social Affairs until the end of 2018) organises the procurements of vaccines. A procured vaccine must have a marketing authorization in Estonia and it must comply with all applicable standards. All European licenses are issued by the European Medicines Agency (EMA) and the National Agency of Medicines will decide on the marketing authorization at the level of a single country. The latter also organizes monitoring of safety.
The Health Board is responsible for the preservation and distribution of nationally procured vaccines. Vaccines reach healthcare providers (such as family physicians, healthcare service providers at schools) with support from the Health Board’s regional offices. After delivery, the healthcare providers (such as family physicians) organize the transport, storage and handling of vaccines.
The delivery of vaccines is documented in writing, and healthcare providers maintain quantitative records of unused and destroyed immunological preparations.
The Health Board also deals with immunisation monitoring and collects immunisation statistics from healthcare providers (number of people who were given vaccines and vaccination coverage by age group). According to the statistics received, the staff of the Health Board draw up reports that can be seen here (link to the statistics section). This data is an important input for planning vaccine volumes, predicting the epidemiological situation, assessing existing prevention activities, and setting new goals.
Every adult makes their own decision
Vaccination is voluntary in Estonia and a parent or legal guardian shall make the vaccination decision on behalf of a child. The information necessary for making a decision can be obtained from a healthcare professional who provides vaccination services (for example, a family physician or a healthcare provider at school).
The vaccines available in Estonia can be divided into two. Some of these are part of the national immunisation schedule and are free of charge when administered at the time set out in the schedule. The rest are administered at the recommendation of a doctor or if the person themselves expresses their wish to get vaccinated; a fee is charged for vaccinations like this.
Before vaccination, the person’s state of health is checked and any potential contraindications are identified. If any contraindications are found, the person shall not be vaccinated or the vaccination shall be temporarily postponed.
Vaccination is conducted by professionals
Vaccination injections are conducted by doctors or nurses who have undergone relevant training. In the case of patients on their list, the vaccination is arranged by a family physician or nurse; but for school-age children and adolescents, this shall be done by the healthcare provider at school. Vaccinations are also carried out at outpatient centres (infectious disease and travel medicine offices, women's centres) and private practices.
After vaccination, a corresponding entry is made to digital health data and the immunisation passport. The latter remains in the possession of the patient and should always be taken along when going in for a vaccination. An immunisation passport may be required, for example, to study abroad or travel abroad.
The immunisation passport is given to a newborn's parent in the maternity ward; others receive it from their family physician or other healthcare provider.
Emergency medicine departments provide rabies or tetanus vaccination to people who have been attacked by an animal or experienced some other relevant trauma. Vaccinations administered in the framework of emergency aid are free of charge.