‘Women key to family health’

Editorial Team

Editorial Team

April 7th, 2015

Editorial Team

‘From taking care of sick children and elderly parents to encouraging husbands to see their doctor, women are central to keeping families in good health, according to a leading women’s health advocate. Should they embrace flu vaccination for kids? ’

EU-puts-spotlight-on-childhood-immunisation“Women are custodians of family health,” says Hildrun Sundseth, President of the European Institute for Women’s Health (EIWH). “Even though I was working when my children were young, it often fell on me to look after them when they were sick.”

Hildrun SundsethThat is why Sundseth has become an outspoken advocate for vaccination, noting that diseases such as flu and measles frequently disrupt family life, forcing children to miss school and parents to miss work.

Read: Parents: can you afford to take this week off work?

“Vaccination is a key public health tool for preventing infectious diseases but despite past successes, the benefits are currently not fully appreciated by society,” she says. “Rather than viewing vaccination as a cost, we should consider it to be a tool for keeping people out of hospital so we can all get on with our busy lives.”

Beyond the influence on their own families, women also play a central role in protecting against the spread of infectious diseases in communities, according to the EIWH President.

“By having yourself vaccinated you also protect people who are too young or too sick to be immunised,” she told the European Roundtable on Seasonal Influenza in Brussels, sponsored by AstraZeneca.

Sundseth also argued that vaccination can help to reduce healthcare inequalities by giving all children a healthy start in life. And, as poorer parents can least afford to miss work, reducing childhood illness also contributes to broader social equality.  

Children & flu

This message was echoed by the data presented by Professor Alistair McGuire and Sam Keeping of the London School of Economics (LSE).

Children with influenza have high rates of absenteeism and even siblings of sick kids miss an average of 1.3 days of school, with many missing a week or more.

Between 11.2% and 61% of Western European parents take time of work to care for a child with flu, Professor McGuire said. “If you’re a salaried worker it’s somewhat easier. The impact is greatest for people with casual or lower-end jobs who may not be paid if they cannot go to work.”

Two countries hit flu jab target

In 2009, health ministers from around Europe pledged to vaccinate 75% of high-risk individuals against seasonal influenza by the winter of 2014-2015.

Older people, pregnant women, young children and those will chronic medical are most likely to suffer serious complications if infected by an influenza virus.

But, six years on, most countries have fallen well short and some are not collecting information on vaccine coverage. While all 28 EU countries target older people and those with chronic medical conditions, only the UK and the Netherlands have reached the 75% target set in 2009.

This is a slight improvement on last year when just one country – the Netherlands – had kept its commitment. 

EU data show that for some high-risk groups, flu vaccination coverage rates are not tracked in several countries. For example, flu vaccine uptake among pregnant women is known in just seven of the 28 countries.

Karin Kadenbach, a Member of the European Parliament from Austria, said flu is often neglected by the public and by politicians.

“There are between 250,000 and 500,000 deaths from flu annually. This equates to the population of Iceland dying form a disease that can be easily prevented by vaccination,” she said.

Last December, EU health ministers agreed a statement calling for closer cooperation on using vaccines as “an effective public health tool”.

The European Commission is holding a high-level hearing later this month in Luxembourg to discuss how national governments can move closer to the 75% target they set themselves.

He said the burden of influenza among children is relatively high and that they are very important in the transmission of the disease – i.e. children represent a high proportion of flu cases every year and frequently pass the virus to vulnerable groups such as young siblings and their grandparents.

This has prompted the US, Canada and the UK to recommend vaccinating healthy children against flu. In Europe, just eight countries have recommended vaccination of children and/or adolescents but, of these, only Finland, Latvia and the UK provide the vaccine for free.

“Preliminary evidence from the UK suggests there is a persuasive argument for vaccinating children against influenza, particularly in countries with suitable infrastructure and where uptake is low among at-risk groups,” said Professor McGuire.

Read: Should all kids have the flu vaccine?

While health systems vary across Europe, data from the UK and North America are piling up on the impact of flu on children, vaccine effectiveness, and on the question of whether protecting healthy kids from flu is good value for money from an economic perspective.

LSE’s Sam Keeping said that assessing the value of vaccination is not the same as measuring the cost-effectiveness of medicines. This is because protecting against infectious diseases helps the person receiving the vaccine as well as those around them.

“Infectious diseases are not the same as, for example, cholesterol medicines. A vaccine directly protects vaccinated individuals from disease – or reduces the severity of diseases – but it also indirectly protects others,” he said.

Measuring the indirect impact of flu vaccination on children, such as the reduced need for parents to miss work, should also be considered when economists ask whether it represents value for money.

“Many of the standard models used to evaluate the economic impact of healthcare interventions fail to capture the true value of vaccination,” said Keeping.

Economic studies that take account of the indirect impact of childhood flu immunisation indicate that the policy is cost-effective, he added.

Prof McGuire said that as more information becomes available, European countries would have to decide whether to continue targeting flu vaccine campaigns towards groups at risk of complications – such as older people and those with chronic illness.

An alternative would be to include healthy young people given their role in ‘onward transmission’ of the diseases. “This would be a more preventive approach… It can be hard to shift money to a programme where the benefits arrive in the future,” he said.