Background and Objective:
Identifying barriers and drivers towards health protective behaviours is an important step when designing interventions because a one-size-fits-all approach may not reach the whole population. The objective of this project is developing, testing and evaluating targeted interventions for underserved groups during pandemics in the Netherlands. We did so by using the Tailoring Immunization Programmes (TIP) approach developed by the World Health Organization (WHO). We now present the findings of the situation analysis. The aim was to get an overview of existing barriers and drivers to COVID-19 vaccination, testing and adherence to measures, and the interventions initiated in the Netherlands.

Methods:
We conducted a literature scan followed by semi-structured interviews with 23 experts. The data were discussed and enriched during a national expert meeting facilitated by the Pandemic and Disaster Preparedness Center (PDPC) and the WHO regional office for Europe.

Results:
The findings revealed that underserved groups are heterogeneous, with different and multifactorial barriers (e.g. mistrust in the government, mis- and disinformation, accessibility) and drivers (e.g. self-protection, moral duty to protect others). Research has predominantly focused on vaccination behaviour among the general population. Over 45 interventions and projects were identified. These interventions were designed with limited use of behavioural insights, due to limited available qualitative research and lack of time during the crisis to gain such insights.

Conclusion:
More research is needed to understand the differences between underserved groups. Although many interventions were initiated, there is a need to design tailored interventions informed by insights, and the need for monitoring and evaluation. In the next phase of this project, we will explore the barriers and drivers to COVID-19 vaccination among elderly migrants using a qualitative approach. These results will be used to develop tailored interventions to improve vaccination uptake and can inform long-term pandemic preparedness and response.