Abstract
BackgroundVaccination is currently the most effective means of preventing influenza infection. Yet evidence of vaccine performance, and the impact and value of seasonal influenza vaccination across risk groups and between seasons, continue to generate much discussion. Moreover, vaccination coverage is below recommended levels.MethodsA model was generated to assess the annual public health benefits and economic importance of influenza vaccination in 5 WHO recommended vaccination target groups (children 6 – 23 months of age; persons with underlying chronic health conditions; pregnant women; health care workers; and, the elderly, 65 years of age) in 27 countries of the European Union. Model estimations were based on standard calculation methods, conservative assumptions, age-based and country-specific data.ResultsOut of approximately 180 million Europeans for whom influenza vaccination is recommended, only about 80 million persons are vaccinated. Seasonal influenza vaccination currently prevents an annual average of between 1.6 million and 2.1 million cases of influenza, 45,300 to 65,600 hospitalizations, and 25,200 to 37,200 deaths. To reach the 75% vaccination coverage target set by the EU Council Recommendation in 2009, an additional 57.4 million person would need to be vaccinated in the elderly and other risk groups. By achieving the 75% target rate set in EU-27 countries, average annual influenza- related events averted would increase from current levels to an additional +1.6 to +1.7 million cases, +23,800 to +31,400 hospitalization, +9,800 to +14,300 deaths, +678,500 to +767,800 physician visits, and +883,800 to +1,015,100 lost days of work yearly. Influenza-related costs averted because of vaccination would increase by an additional + €190 to + €226 million yearly, in vaccination target groups.ConclusionsFull implementation of current influenza vaccination recommendations of 75% vaccination coverage rate (VCR) in Europe by the 2014–2015 influenza season could immediately reduce an important public health and economic burden.
Highlights
Vaccination is currently the most effective means of preventing influenza infection
Ryan et al estimated that 100% vaccination coverage in risk groups in France, Germany, Italy, Spain, and the UK would result in a savings of €1.59 billion in reduced hospitalizations alone [7]
Our approach was adapted from the model published by Ryan et al who estimated the potential benefits from seasonal influenza vaccination in Europe with 100% vaccination coverage [7]
Summary
Vaccination is currently the most effective means of preventing influenza infection. Yet evidence of vaccine performance, and the impact and value of seasonal influenza vaccination across risk groups and between seasons, continue to generate much discussion. In a sample of European countries influenza mortality rates ranged from around 57.05/100,000 in Spain (1999 and 2005) [4] to 160/ 100,000 in Slovakia (1982–2000) [5]. Ryan et al estimated that 100% vaccination coverage in risk groups in France, Germany, Italy, Spain, and the UK would result in a savings of €1.59 billion in reduced hospitalizations alone [7]. The impact on health spending was significant with one estimate putting the cost of influenza in France at € for doctors’ fees, pharmaceuticals, and compensation for sick-days for the month of January 2013 alone and €220 million for the season by the end of March 2013 [11,12]. The total impact of an influenza epidemic (including direct and indirect costs) in industrialised countries has been estimated to reach € [13]. Extrapolating from the estimated costs of the 1996–1997 influenza epidemic in Germany (approximately € million), and a French estimate of an annual € million in costs, the costs in the EU would range from €6 billion to €14 billion annually
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