Seasonal influenza vaccination

in the WHO European Region

preliminary resultsWHO workshop on sentinel influenza surveillance,

16-17 November, 2011 Istanbul, Turkey

Pernille Jorgensen | Influenza and other Respiratory PathogensWHO Regional Office for Europe

In partnership with the VENICE Collaboration and ECDC

Background influenza vaccines

Influenza vaccines introduced 1940s

Vaccination is primary means of preventing influenza today

Excellent safety recordHigh efficacy:70-90% in healthy adults…but lower in the elderly...- 60% in persons >60 years- 30-40% in persons >85 years

Priority groups for influenza vaccination

Reference: WHO/Europe recommendations on influenza vaccination during the 2011-2012 winter seasonwww.euro.who.int/__data/assets/pdf_file/0008/152297/EURO_2011_2012_flu_vacc_rec.pdf

Elderly Health care workers Pregnant women Residents of

institutions for older persons and the disabled

Individuals >6 months with underlying chronic medical conditions

First VENICE survey on seasonal influenza vaccination in WHO

European Region

Aims and objectives

Aim

To assess progress toward the WHO goal of 75% influenza vaccine coverage in elderly by 2010

Specific objectives Identify country specific vaccine

recommendations Describe influenza vaccine coverage in

2008/2009 and 2009/2010 Describe influenza vaccination implementation Provide a baseline from which to measure

future improvements in seasonal influenza vaccine uptake

Methods

Self-administered questionnaire to national vaccination focal points, 53 WHO Member States in August 2011

Preliminary results

Response from 46/53 (87%)

Response (1.11.2011)NoYes

National influenza vaccination programmes

43/46 (93%) countries had access to seasonal influenza vaccines in 2008/2009 season

No response

Seasonal vaccine 2008/2009No vaccine purchasedVaccine available

Seasonal influenza vaccine doses available relative to total

population

No response

Vaccine available

% doses relative to population, 2008/20090>0 <11- 55 - 1515 - 30

Range from <1% to 23% Note: Limited

vaccine availability may reflect risk group vaccination policies

National recommendationsfor vaccination seasonal

influenza Elderly

Pregnancy

Clinical riskgroups

HCW hospital + outpatient

National recommendationsclinical risk groups

National recommendationsfor vaccination seasonal

influenza

Children

Principal outlets for administration of seasonal influenza vaccine &

cost

Cost of single dose vial or prefilled syringe (€)

Median: 5.1 EUR

Primary health care clinics are most important site for seasonal influenza vaccination in 90% of countries

Vaccine uptake in elderlyEU/EEA countries, 2008/2009

75% coverage target

NL UK ES IT BE FR DE IE LX DK NO PT FI SE IS MT SK HU RO SI PO LT EE0

20

40

60

80

Influenza vaccination coverageClinical risk groups, 2008-2009

Netherlands Germany Croatia Israel Spain Belarus0

20

40

60

80

100

N=6

Belarus Armenia Uzbekistan Albania Croatia Hungary Spain Germany Montenegro0

20

40

60

80

100

Influenza vaccination coverage

Health care workers, 2008-2009

N=9

Seasonal influenza vaccination campaigns

81% produced specific information for public and health professionals

73% made use of media campaigns– 93% TV– 93% News paper adds– 87% Radio– 73% Posters

Conclusions

Most countries in the Region have access to seasonal influenza vaccine

Similar recommendations for “traditional” risk groups in the Region

Only, 1 country reached WHO 2010 target of coverage >75% among elderly

Low coverage in health care workers Cost of influenza vaccine very similar Frequent use of media campaigns to

promote influenza vaccination

Key challenges

Limited vaccine uptake monitoring–Difficult to monitor progress–Difficult to monitor impact

Low vaccine uptake Limited vaccine access in some

countries

Suggested readings

www.who.int/wer/2004/wer7903.pdf

Hollmeyer HG et al: Influenza vaccination of health care workers in hospitals- a review of studies on attitudes and predictors.

Vaccine. 2009 Jun 19;27(30):3935-44.

Babcock H et al: Mandatory Influenza Vaccination of Health Care Workers: Translating Policy to Practice Clin Infect Dis. (2010) 50 (4): 459-464.

Mereckiene J et al: Differences in national influenza vaccination policies across the European Union, Norway and Iceland 2008-2009.

Euro Surveill. 2010;15(44)

Next steps - country plans

Change seasonal vaccine recommendations and include pregnant women and persons with morbid obesity

Prioritization of risk groups in settings with limited quantity of vaccines

Assessing cost-benefit of influenza vaccination programme in different settings

Evaluating vaccine uptake Improve perception of influenza vaccines

in the public

Sincere thanks to

All national focal points who provided the data

VENICE– Jolita Mereckiene– Suzanne Cotter– Luca Dematte

ECDC– Angus Nicoll

WHO– Anna Bolokhovets– Annemarie Wasley– Guido Maringhini

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