Seasonal influenza vaccination rates must be tackled at EU level

Europe needs 'renewed ambition and increased leadership' to combat the burden of seasonal influenza, argues Karin Kadenbach.

By Karin Kadenbach

30 Mar 2015

Despite some improvement in coverage rates, the European Union lags in meeting its own seasonal influenza vaccination targets. MEPs have called for renewed ambition and increased leadership from the EU to improve vaccination rates in Europe, following the launch of new research by the London school of economics and political science (LSE).

At a recent roundtable event I hosted, participants heard that seasonal influenza continues to represent a huge challenge to healthcare systems and policymakers across the EU. Globally, seasonal influenza affects between five to 10 per cent of adults and 20 to 30 per cent of children per year and is associated with high mortality and morbidity rates. This places a significant clinical and economic burden on member states.

Since the adoption of the European council recommendation on seasonal influenza vaccination in 2009, there have been some positive developments. Almost all member states now have national and or regional vaccination policies for seasonal influenza in place, and the burden of the disease has been recognised by the European institutions.

However, most states are still far short of the recommended seasonal influenza vaccination rate of 75 per cent. Only the Netherlands is meeting or exceeding the target for vaccination of the elderly, while England is close to this threshold.

"Most states still far short of the seasonal influenza vaccination recommended levels of 75 per cent"

In addition, the EU is falling behind in the global understanding of the disease burden and transition towards vaccinating children against seasonal influenza. In Central and South America for example, paediatric influenza vaccination programmes of all children within the recommended age ranges are in place in 25 countries and in some countries, including Costa Rica, Chile, Brazil and Mexico, coverage rates higher than the recommended coverage level of 75 per cent are being achieved.

These figures illustrate the need for increasing the momentum in the fight against seasonal influenza if the EU wants to deliver on its ambitions and remain an effective global leader in the battle against this condition.

Presenting research findings on childhood and adolescent influenza vaccination, Alistair McGuire of LSE health argued that childhood seasonal influenza vaccination could offer some states an opportunity to not only reduce the substantial burden of disease in this age group, but to also provide indirect protection for the wider population through herd immunity.

This concept means that if enough people in a community are vaccinated against seasonal influenza through the use of new vaccines, it may be harder for the virus to pass between those who are not vaccinated, as the likelihood of coming into contact with a carrier is greatly reduced. The use of childhood seasonal influenza vaccination therefore has the potential to reduce the overall burden of influenza on European healthcare systems.

Highlighting the economic and public health benefits of indirect protection, McGuire said, "Vaccination is an effective public health tool and expanding programmes to children, who often spread the disease, can help expand herd immunity in Europe and protect more people from being affected by this burdensome condition."

Looking to the UK, where all children between the ages of two and 17 are immunised, the LSE study recommends that states, and particularly those with younger populations and a high population density, should begin piloting their own paediatric vaccination programmes to establish the value of expanding existing vaccination programmes with seasonal influenza.

Participants at the LSE event agreed that the EU has a duty to foster political leadership and provide a legislative framework to encourage EU member states to implement comprehensive vaccination policies which encompass all age groups. If this is not done, the EU risks losing the battle against seasonal influenza to the detriment of citizens.

Five years following the implementation of the council recommendation, it is time to reflect on lessons learned and consider what else can be done to ensure the EU does not fall behind the rest of the world. The substantial burden of seasonal influenza will not be reduced unless new innovative vaccination policies, including herd immunity, are prioritised to effectively protect at-risk groups, including children and adolescents. I have called upon the European commission and the council to update the 2009 council recommendation accordingly.


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