EU countries miss flu vaccination target (except for one)

Gary Finnegan

Gary Finnegan

October 17th, 2023

Gary Finnegan

‘European health ministers agreed on a target of vaccinating 75% of older people in 2009 ‒ almost all countries are still falling short. The Steering Group in Influenza has published recommendations on how to turn the tide.’

Older people, pregnant women and those with chronic disease (such as diabetes and lung conditions) are at highest risk of severe illness and death if infected with a flu virus. 

To help reduce the impact of the annual flu epidemic on vulnerable groups, as well as the impact this can have on health systems and the wider economy, governments are supposed to be pushing to vaccinate at least 75% of people aged 65 and older. This target was agreed by health ministers in 2009.

So, how are they doing? 

The latest data, published by the European Centre for Disease Prevention & Control (ECDC) ahead of EU Flu Day (11 October), presents a mixed picture. Almost all countries are missing the target, but there are signs of improvement in most countries. 

Vaccine uptake appears to have risen during the COVID-19 period as awareness of respiratory illness, and strong flu vaccine campaigns, prompted people to consider vaccination. Several countries also introduced childhood flu vaccination during this time. 

However, there is a strikingly broad range of results, with several countries still a very long way from their goal. (It’s 4.5% in Latvia.) It should be noted that several EU Member States, including Estonia and Bulgaria which have reported low uptake in the past, did not report vaccine uptake to the ECDC. They are not obliged to do so. 

Top of the class: Denmark, with exactly 75% vaccination among older people for the 2020-2021 season ‒ the latest flu season for which data has been made public.  

Looking at data for the whole adult population, uptake rates are significantly lower in all countries. And, again, the range is broad. 

Isabel De la Mata, Principal Adviser for Health and Crisis Management at DG SANTE, European Commission, said EU Member States had committed to reaching the target, but the data show some are doing much better than others. There is also a wide range of national recommendations, with many (but not all) governments advising that children be vaccinated and only a handful actively supporting vaccination of pregnant women. 

[What does your country recommend? See the ECDC’s vaccine scheduler]

In addition to vaccination, she highlighted the need to invest in detection and surveillance systems so that health authorities can take informed action. ‘In order to act, we need to know where outbreaks are happening,’ she said, highlighting the €100 million of EU4Health funds dedicated to supporting Member States in strengthening national surveillance systems. 

How to fix it

Speaking at an EU Flu Day event in the European Parliament, Prof Colin Russell, member of the Steering Group on Influenza Vaccination, called on regional, national and European policymakers to do more to increase flu vaccine uptake. He shared a series of recommendations designed to empower healthcare professionals to engage with the public, including awareness campaigns, training materials, and sharing examples of good practices. 

‘Up to 50 million people in the EU are infected with flu every year,’ he said. ‘Many thousands of those will die from a preventable disease; tens of millions of work days will be lost, and health systems will face a significant burden. Vaccination against influenza is a cost-effective way to prevent infection, save lives and maintain economic activity.’

Several speakers at the event highlighted the central role of doctors, nurses and pharmacists in increasing access to vaccination, and in championing vaccination in their communities. Practical vaccination skills as well as communication training are widely viewed as essential. 

Dr Emilie Karafillakis, European research lead at the Vaccine Confidence Project and member of the Steering Group, noted that only 30% of health professionals say they feel confident to speak about vaccines, with just 5% believing they have had enough education on the topic. However, 95% say they are interested in receiving more training on the subject. 

There are also concerns that vaccine uptake among healthcare professionals is too low. In several European countries that collected and shared data, less than half of health workers had the flu vaccine during the worst period of the COVID-19 pandemic when most countries urged health staff to have their jabs.  

As Europe faces another winter, the ECDC and WHO have expressed concern about the spread of flu, COVID-19 and RSV, all of which were in circulation last year. Last year hospitals in several countries were under significant pressure from these respiratory diseases. This year is the first in which vaccines for all three are available in Europe. The question is whether the public will roll up their sleeves. 

Further reading

State of Vaccine Confidence in the EU 
New study: Most Europeans trust vaccines
Policy Recommendations of the Steering Group on Influenza