Flu vaccine: did your country hit its target?

Gary Finnegan

Gary Finnegan

January 20th, 2020

Gary Finnegan
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‘In 2009, Health Ministers from across the EU signed up to modest target: to vaccinate 75% of older people against flu. 10 years on, no EU country has kept its promise’

On 22 December 2009, health ministers from every EU Member State made a new commitment: to vaccinate at least three quarters of all residents aged 65 years and older. Now new data from Eurostat, the EU statistics agency, shows governments have failed.

Story highlights

  • 44% of people in Europe aged 65 years and older are vaccinated
  • No EU country has hit its target to vaccinate three out of four people in that risk group
  • There are no penalties for missing this target
  • Older people are just one key target group
  • WHO says pregnant women are the top priority, followed by health workers and people with chronic diseases such as diabetes, asthma and heart failure

 

No EU Member State has reached its 75% target and the rate across the EU is 44.3%. However, there are no political consequences: while there are penalties for breaching EU rules on carbon emissions, budget deficits or employment regulations, there is no sanction for missing vaccination targets.

The flu vaccination targets are considered to be ‘soft law’ rather than ‘hard law’, meaning they are not legally binding. Strict EU health targets are rare because health is a matter for national governments rather than a European responsibility.

It may have sounded like a modest goal. After all, reaching just three quarters of a key target group is still a long way short of protecting all at-risk citizens.

It would still leave 25% of older people unvaccinated. And the agreement reached at the 2009 European Council of health ministers ignored other key groups such as pregnant women and people with chronic conditions.

However, some countries were working from a very low base, with flu vaccination rates in single digits – hence the compromise agreement not to aim for universal vaccination in risk groups. There was a clear East-West divide: most EU members in the east had very low flu vaccination rates but boasted infant immunisation rates that were often the envy of their western neighbours.

Unhappy anniversary

Fast forward a decade and the East-West divide remains. Top of the table for 2018/2019 is the UK at 72.6%, followed by the Netherlands with 64%. These countries are the only ones to have ever crossed the 75% threshold – but have not sustained earlier progress.

And yet, they are the best of a bad bunch. Six countries (Romania, Lithuania, Slovakia, Slovenia, Latvia and Estonia) report flu vaccine uptake rates below 20%. A further six countries (Austria, Belgium, Bulgaria, Cyprus, Greece and Poland) did not report 2017/2018 data.

Modest improvements have also been recorded by Iceland, Ireland, Finland and Portugal but, overall, the picture is discouraging. 

As experts call on policy makers to focus on life-course immunisation, the dire flu stats show much work remains to be done. In its latest report on the 2019/2020 flu outbreak, the European Centre for Disease Prevention & Control (ECDC) says older people are at particularly risk from the strain of flu virus currently circulating.

While the ECDC guidelines follow the European Council’s target of reaching 75% of older people, the WHO lists pregnant women as the top priority for flu vaccination. Some countries in Europe are rolling out campaigns aimed at boosting flu vaccine uptake during pregnancy, but others are less active.

 

Despite the apparent lack of urgency in some European countries, flu remains a serious burden on individuals, communities and health systems. Each year, it affects 5-10% of the world’s population resulting in up to 650,000 deaths and 3 to 5 million cases of severe illness worldwide.

In Europe, flu puts significant pressure on hospital systems during the winter months and is responsible for thousands of ‘excess deaths’ i.e. people who would not have otherwise died at that time.

Dr Pasi Penttinen, ECDC Head of Influenza Disease Programme, acknowledged that improving vaccine uptake is the best way to address the annual epidemic. ‘Achieving high vaccination coverage rates for those particularly at risk of developing severe complications remains a serious public health challenge,’ he said.

‘The best way to prevent or minimize severe disease from influenza among vulnerable groups is timely vaccination, even though the effectiveness of the vaccine varies depending on the virus in circulation. Sufficient vaccination coverage also saves healthcare systems money in decreased consultation rates and hospitalisations.’

An event will be held in the European Parliament on 21 January to mark the 10-year anniversary of the European Council commitment to improve flu vaccination rates in older people. Find out more

 

Comments

  1. Peter Morron

    Peter Morron

    May 1st, 2020

    Poland have a significantly low death rate from Covid-19 and here is a reference stating that only 3% of Poles get the flu jab
    https://www.vaccinestoday.eu/stories/from-poland-to-scotland-vaccine-myths-cross-borders/

    Ukraine are in a similar boat, not even hit 300 deaths yet, and look to be even less vaccinated than Poland
    http://journal-ene.gr/wp-content/uploads/2018/07/status-vaccination-against-influenza.pdf

    Czech Repuplic same. 240 deaths

    https://news.expats.cz/weekly-czech-news/flu-season-is-coming-to-prague-and-its-not-too-late-to-get-vaccinated/

    Dr Judy Mikovits has some interesting info on YouT*be

  2. Liz Moss

    Liz Moss

    May 2nd, 2020

    So this mentions the study into children I mentioned.

    I still see nothing that disproves the link.

    Only research that doesn’t support the link based on coronavirus research prior to C19

    But we are now post C19 and it is a game changer in coronavirus infections unfortunately

    • Ray Eade

      Ray Eade

      May 3rd, 2020

      Where have all our posts gone – have we got a nerve???

      • Ray Eade

        Ray Eade

        May 3rd, 2020

        hit a nerve even!

      • Gary Finnegan

        Gary Finnegan

        May 4th, 2020

        Hi Ray, are some of your comments disappearing?
        Nothing has been removed as far as I can see. Let me know and I can ask someone to look into it.

    • Gary Finnegan

      Gary Finnegan

      May 4th, 2020

      Hi Liz, the study you mentioned is also from before C19. My reading of that ‘fact check’ article was that it was attempting to address the paper that looked back at 2017-2018 data.
      I agree that we are in a new situation now with a new virus and there is a lot we cannot know yet.

      • Liz Moss

        Liz Moss

        May 7th, 2020

        Yes, that is why I am saying this needs looking into. Previous studies showing a virus interference are worrying . We need to know if this is happening.

        You cannot say it’s not happening based on previous studies. I cannot say it is happening based on previous studies.

        I presume flu vaccine status, prescribed medication etc are all being looked at as risk factors for severe immune system response to covid 19

        and this is the crux for me. It would seem some countries populations experience more cases of C19 that need ICU treatment that lead to death than others. And it is the bodies own response that is causing organ failure. So what is causing that? Is it really just ‘your in an at risk category’?

        We need to know why some countries death rates are much higher. Is it really only attributed to social distancing?

  3. Janet

    Janet

    May 5th, 2020

    Early on when Italy and Spain were losing thousands to coronavirus, experts told us it was because of their elderly population, but now I’m watching mexico, a developing country with a low life expectancy, but a surprisingly high uptake of quadrivent lose almost the same amount of people.
    Why would mexico be losing so many people, when their population is so young?

  4. Alex Biss

    Alex Biss

    May 8th, 2020

    Just going back to a point raised by Ray a while back: Doesn’t Belgium administer the quadrivalent vaccine to its over 65s yet Belgium has one of the worst death rates of all. I think Sean McMahon now recognises this fact.

    Also, I think there is as much regional variation in the death rate as there is from country to country (looked at as a proportion of the over 65s who have died from Covid-19), and this suggests that national vaccination programmes are not to blame. Below is a link to a map that shows that the death rate is more likely linked to i) population density, ii )how long the region has had the coronavirus for and iii) its level of internationalism plus a load of other factors that are too numerous to mention (e.g. effectiveness of government policy).

    For example, Portugal stands out for its low death rate (compared to Spain) and I think administers the quadrivalent to its over 65s, but looked at region-by-region it seems like part of a natural trend where the death rate declines with distance from the Madrid and Catalonia hot spots. Likewise, Brussels and Lombardy are other hot spots.

    https://drive.google.com/file/d/1iPO2h-hq32kZ8ooGH3R4Wu2UowDJiKOz/view?usp=sharing

    (Numbers underlined in green are country rates, numbers in black are highlighted regional rates. Data is a few days old, but I think the patterns still hold).

    • Janet

      Janet

      May 9th, 2020

      Belgium does seem to be the exception, pity they’re guessing their coronavirus fatalities and not testing…is there another country like Belgium low quadrivent use, but high tested fatalities?

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