In 2009, health ministers from across the EU set a target for their countries: to vaccinate at least 75% of older people against influenza. This has proven a challenge – most have never hit the target; some are a very long way off.
But a lot has happened in the meantime, including a global COVID-19 pandemic, during which flu vaccination rates increased. In several countries, people can now have their flu and COVID-19 vaccines at the same time.
Read more: Could new RSV vaccines ease winter pressure on hospitals?
On top of that, new vaccines have been developed against respiratory syncytial virus (RSV), and there is a growing realisation that people living with long-term conditions – such as cardiovascular disease and diabetes – are at higher risk of serious illness if they catch a respiratory virus.
Fifteen years since the landmark flu target was set, Europe is heading into another flu season with experts warning of a ‘tripledemic’ of flu, COVID-19 and RSV. Some health stakeholders believe it is time to rethink the 75% flu vaccination target.
Spanish MEP Dolors Montserrat is calling for the European Council to update its goal to reflect the changes seen since 2009. The target, she said in a message on EU Flu Day, should include vaccination against other respiratory viruses and aim to protect all at-risk individuals.
MEP Montserrat is Co-Chair of the Steering Group on Influenza, a group of academics, scientists, health workers and civic society organisations advocating for improved flu vaccine uptake. The Steering Group hosted an event in the European Parliament this month (16 October 2024) to highlight the opportunity to address the 70,000 EU deaths caused by flu every year.
A family’s testimony on EU Flu Day
Among the highlights of the EU Flu Day event were the contributions of Anais and Davy Cotting. Anais, a healthcare worker, developed serious complications of influenza which have had a life-changing impact. Davy has written about the experience, and the effect on their young family: ‘How my wife’s flu infection changed our lives forever’
Anais described the physical and emotional pain she has suffered, including foot amputations and reduced respiratory function. She can no longer work, and Davy now cares for her and their daughter full-time.
‘The flu took so much from us. I cannot live as I did before,’ she said. ‘We are sharing our testimony so that people understand [the impact of influenza]. Flu is often thought of as being like a cold, but it’s much more serious than that. It can be prevented through vaccination – not just for the elderly or the vulnerable, but for everyone.’
Putting prevention at the heart of health
The importance of immunisation for people living with ongoing health conditions came into focus during COVID-19. In many countries, vulnerable groups were prioritised for COVID-19 vaccination.
However, patient advocates want to see this preventative approach continue given the additional risks faced by people with heart disease or those who have previously suffered heart attack or stroke.
Dr Birgit Beger, Chief Executive Officer, European Heart Network, said the inflammatory effect of the body’s immune response to the flu virus can lead to inflammation of heart muscle. Flu vaccination protects against heart attack and stroke, she noted.
‘We cannot separate infectious diseases and noncommunicable diseases [such as heart disease]; they are interlinked,’ she said. ‘It is important to take the preventative measures we have in order to reduce the impact on patients and on healthcare systems.’ She added the future EU cardiovascular strategy should emphasise the positive impact of flu vaccination.
Data in the spotlight
Digital tools can help healthcare professionals identify at-risk patients who should be prioritised for flu and other vaccination. Dr George Kassianos, Royal College of GPs in the UK and a Board Member of ESWI, said information systems give health professionals convenient ways to send reminders to patients.
‘In our [GP] practice, we know who has had the vaccine; we can identify older adults, pregnant women and people in risk groups that we need to contact; and patients can make their appointments online,’ Dr Kassianos said.
Read more: Adult vaccination: data collection key to hitting targets
Denmark is one of the few countries with consistently high flu vaccine uptake. This is attributed, in part, to its use of data. Dr Tyra Grove Krause of the Statens Serum Institut, Denmark, said the national patient register has helped to improve coverage while avoiding unnecessarily vaccinating people who cannot remember whether they have already had their vaccine.
‘We can also document the impact of vaccines on the burden of disease, and maintain trust in vaccines by identifying safety signals and addressing concerns quickly.’
While the benefits of digitalisation are significant, it can exclude patients with low digital literacy. That is why patients in Denmark who cannot use digital tools, are sent physical letters to remind them that they should be vaccinated.
Read more: How the Danish Vaccination Registry became a cornerstone of Denmark’s immunisation service
Dr Vytenis Andriukaitis, a former European Commissioner for health who is now an MEP, said digital immunisation records should be used to help people keep track of their own vaccination history. This opt-in tool would be a particularly valuable tool for those moving between EU Member States.
Read more: European Vaccination Card will be piloted in five countries
