Influenza vaccination coverage rates in five European countries during season 2006/07 and trends over six consecutive seasons

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Abstract

Background

The objectives of the survey were to identify the level of influenza vaccination coverage in five European countries between 2001 and 2007, to understand the drivers and barriers to vaccination, to assess vaccination intentions for the winter 2007/08 as well as major encouraging factors for vaccination.

Methods

Between 2001 and 2007, representative household surveys were performed with telephone or mailed (France) interviews of individuals aged 14 and above. The questionnaire used in the UK, Germany, Italy, France and Spain was essentially the same in all seasons. The data were subsequently pooled. Four target groups were defined for the analysis: 1) persons aged 65 years and over; 2) persons working in the medical field; 3) chronically ill persons and 4) combined target group composed of individuals belonging to one or more of the previous groups 1, 2 or 3.

Results

In 2006/07, vaccination coverage was, 25.0% in UK, 27.4% in Germany, 21.8% in Spain, 24.2% in France and 24.4% in Italy. During six influenza seasons (2001–2007), vaccination coverage showed a slight positive trend in the five countries (p ≤ 0.0001). In the elderly (≥ 65 years), across all countries, no significant trend was seen; the vaccination rate decreased non-significantly from a peak of 64.2% in season 2005/06 to 61.1% in season 2006/07. The most frequent reason for getting vaccinated was a recommendation by the family doctor or nurse (51%), and this was also perceived as the major encouraging factor for vaccination (61%). The main reason for not getting vaccinated was feeling unlikely to catch the flu (36%).

Conclusion

In the UK, Germany and Spain, influenza vaccination coverage rates in season 2006/07 dropped slightly compared to the previous season. However, a trend of increasing vaccination coverage was observed from 2001/02 to 2006/07 across Europe. The family doctor is the major source of encouragement for individuals getting vaccinated. Efforts to overcome the barriers to vaccination need to be put in place to reach the WHO objective of 75% coverage in the elderly by 2010. This is a major challenge to be faced by governments, healthcare workers and healthcare organisations.

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Most cited references 30

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Influenza vaccination of healthcare workers: a literature review of attitudes and beliefs.

F. Hofmann, C Ferracin, G. Marsh … (2006)

Influenza vaccination coverage among healthcare workers (HCW) is insufficient despite health authority recommendations in many countries. Numerous vaccination campaigns encouraging HCW to be vaccinated have met with resistance. We reviewed published influenza vaccination programs in healthcare settings to understand the reasons for their success and failure, as well as the attitudes and beliefs of HCW. Relevant articles published up to June 2004 were identified in the MEDLINE/Pubmed database. Thirty-two studies performed between 1985 and 2002 reported vaccination rates of 2.1-82%. Vaccination campaigns including easy access to free vaccine and an educational program tended to obtain the highest uptake, particularly in the USA. Yet, even this type of campaign was not always successful. Two main barriers to satisfactory vaccine uptake were consistently reported: (1) misperception of influenza, its risks, the role of HCW in its transmission to patients, and the importance and risks of vaccination (2) lack of (or perceived lack of) conveniently available vaccine. To overcome these barriers and increase uptake, vaccination campaigns must be carefully designed and implemented taking account of the specific needs at each healthcare institution.

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Vaccines for seasonal and pandemic influenza.

John J Treanor, Kristin L. Nichol (2006)

Seasonal influenza continues to have a huge annual impact in the United States, accounting for tens of millions of illnesses, hundreds of thousands of excess hospitalizations, and tens of thousands of excess deaths. Vaccination remains the mainstay for the prevention of influenza. In the United States, 2 types of influenza vaccine are currently licensed: trivalent inactivated influenza vaccine and live attenuated influenza vaccine. Both are safe and effective in the populations for which they are approved for use. Children, adults <65 years of age, and the elderly all receive substantial health benefits from vaccination. In addition, vaccination appears to be cost-effective, if not cost saving, across the age spectrum. Despite long-standing recommendations for the routine vaccination of persons in high-priority groups, US vaccination rates remain too low across all age groups. Important issues to be addressed include improving vaccine delivery to current and expanded target groups, ensuring timely availability of adequate vaccine supply, and development of even more effective vaccines. Development of a vaccine against potentially pandemic strains is an essential part of the strategy to control and prevent a pandemic outbreak. The use of existing technologies for influenza vaccine production would be the most straightforward approach, because these technologies are commercially available and licensing would be relatively simple. Approaches currently being tested include subvirion inactivated vaccines and cold-adapted, live attenuated vaccines. Preliminary results have suggested that, for some pandemic antigens, particularly H5, subvirion inactivated vaccines are poorly immunogenic, for reasons that are not clear. Data from evaluation of live pandemic vaccines are pending. Second-generation approaches designed to provide improved immune responses at lower doses have focused on adjuvants such as alum and MF59, which are currently licensed for influenza or other vaccines. Additional experimental approaches are required to achieve the ultimate goal for seasonal and pandemic influenza prevention--namely, the ability to generate broadly cross-reactive and durable protection in humans.

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The macro-epidemiology of influenza vaccination in 56 countries, 1997--2003.

(2005)

The WHO Global Agenda on Influenza calls for measuring the progress of national influenza vaccination programs. In response, the Macro-epidemiology of Influenza Vaccination (MIV) Study Group has gathered information on influenza vaccination in 56 countries. During the period 1997--2003, influenza vaccine distribution increased considerably in almost all countries. In 2003, the countries with the highest levels of vaccination (doses distributed/1000 population) were Canada (344), the Republic of Korea (311), the United States (286) and Japan (230). Most countries recommended influenza vaccination for elderly persons and those with high-risk medical conditions, including immuno-compromise. Fewer countries provided public reimbursement for vaccination through national or social health insurance. Higher levels of vaccination were not closely related to higher levels of economic development, but in many instances public reimbursement for vaccination seemed to be associated with greater vaccine use. From 1994 to 2003, the global use of influenza vaccines increased more than two-fold. In 2003, the 56 MIV Study Group countries accounted for approximately 95% of the 292 million doses of influenza vaccine distributed worldwide, and 62% of these doses were distributed within nine vaccine-producing countries in North America, Western Europe, Japan and Australia. However, influenza vaccination was increasing rapidly in many non vaccine-producing countries, and this change has important implications for pandemic vaccination.

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Author and article information

Journal

Journal ID (nlm-ta): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central

ISSN (Electronic): 1471-2458

Publication date Collection: 2008

Publication date (Electronic): 1 August 2008

Volume: 8

Page: 272

Affiliations

[1 ]Institute of Social- and Preventive Medicine, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland

[2 ]European Center of Pharmaceutical Medicine, University of Basel, Blumenrain 23, 4051 Basel, Switzerland

Article

Publisher ID: 1471-2458-8-272

DOI: 10.1186/1471-2458-8-272

PMC ID: 2519082

PubMed ID: 18673545

SO-VID: aaf14fdc-c283-40e8-8971-5ca1454dadd5

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Influenza vaccination coverage rates in five European countries during season 2006/07 and trends over six consecutive seasons

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Abstract

Background

Methods

Results

Conclusion

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Most cited references 30

Influenza vaccination of healthcare workers: a literature review of attitudes and beliefs.

Vaccines for seasonal and pandemic influenza.

The macro-epidemiology of influenza vaccination in 56 countries, 1997--2003.

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