Strategies in recommending influenza vaccination in Europe and US

Abstract

There is potential for influenza vaccine programmes to make a substantial impact on the disease burden. The World Health Organization (WHO) has identified young children, pregnant women, persons with chronic medical conditions, and the elderly as being at risk for severe influenza disease and therefore important groups to be considered for influenza vaccination. Applying the methodology of scoping review of grey and scientific literature we described the European and the US approach to influenza vaccine prevention. Although vaccination remains the most effective means of reducing the incidence and severity of influenza, vaccine uptake in many European countries remains suboptimal (i.e. 45.5% in the elderly, 24% in health care workers, from 49.8% in patients with chronic medical conditions, median 23.6% in pregnant women) and vaccine strategies are not harmonized in particular with regard to vaccinating healthy children. Whereas in the US the vaccine strategies are more standardized across states and vaccine coverage are higher than those reported in EU on average. The integration of different strategies is crucial in order to increase influenza vaccine coverage: public health authorities should encourage healthcare workers to vaccinate themselves, as target category, and to recommend seasonal influenza vaccination to people in the target groups; there should also be structured communication campaigns on influenza and influenza vaccines, directed specifically at these target groups, and an adequate and sustainable funding is also an important factor to achieve higher vaccination coverage rates.

Seasonal influenza vaccination among people with diabetes: influence of patients’ characteristics and healthcare use on behavioral changes

“…2 Profiles are ranked in ascending order of the expected (i.e., predicted by the MSM model) number of seasons with SIV uptake for patients not vaccinated at the beginning of the period. 3 For each profile, all remaining covariates (individual chronic condition score, hospital stays for diabetes/influenza, healthcare use) are set to their mean values. Reading Figure 3a: for a woman not vaccinated at the beginning of the period and younger than 65 years with untreated diabetes, the expected number of seasons with SIV uptake over the next 10 SIV seasons was estimated at 2.6.…”

“…Because people with diabetes are at increased risk of severe complications linked to seasonal influenza, 1 the World Health Organization (WHO) and many national guidelines 2,3 recommend they receive annual seasonal influenza vaccination (SIV). The SIV rate in this population is nonetheless far below WHO's target of 75% in most Western countries, 4 including France (about 30% among those <65 years and 60% among those ≥ 65 years).…”

Factors influencing refusing of flu vaccination among pregnant women in Italy: Healthcare workers’ role

“…In fact, responses can be biased due to the low perception of risk for babies in the last period of gestation. Finally, the study is been conducted in a period full of general distrustful attitudes towards vaccination: Marches Region had in fact the lowest regional vaccination's coverage rate in Italy; this negative attitude could have influenced women's perception of risk‐benefits ratio …”

“…6 In Italy, vaccination is offered for free to all women who, at the beginning of the epidemic season, are in the second or third trimester of gestation. 7 Despite its clinical importance and the health policies, influenza vaccination coverage in pregnant women is low in Europe (23.7%), 8 especially in Italy (2%). [9][10][11] Wider acceptance of maternal immunization has been hampered by the perception that limited data about safety are available.…”

“…Despite its clinical importance and the health policies, influenza vaccination coverage in pregnant women is low in Europe (23.7%), especially in Italy (2%) …”