Abstract
BackgroundIn Germany, annual vaccination against seasonal influenza is recommended for certain target groups (e.g. persons aged ≥60 years, chronically ill persons, healthcare workers (HCW)). In season 2009/10, vaccination against pandemic influenza A(H1N1)pdm09, which was controversially discussed in the public, was recommended for the whole population. The objectives of this study were to assess vaccination coverage for seasonal (seasons 2008/09-2010/11) and pandemic influenza (season 2009/10), to identify predictors of and barriers to pandemic vaccine uptake and whether the controversial discussions on pandemic vaccination has had a negative impact on seasonal influenza vaccine uptake in Germany.MethodsWe analysed data from the ‘German Health Update’ (GEDA10) telephone survey (n=22,050) and a smaller GEDA10-follow-up survey (n=2,493), which were both representative of the general population aged ≥18 years living in Germany.ResultsOverall only 8.8% of the adult population in Germany received a vaccination against pandemic influenza. High socioeconomic status, having received a seasonal influenza shot in the previous season, and belonging to a target group for seasonal influenza vaccination were independently associated with the uptake of pandemic vaccines. The main reasons for not receiving a pandemic vaccination were ‘fear of side effects’ and the opinion that ‘vaccination was not necessary’. Seasonal influenza vaccine uptake in the pre-pandemic season 2008/09 was 52.8% among persons aged ≥60 years; 30.5% among HCW, and 43.3% among chronically ill persons. A decrease in vaccination coverage was observed across all target groups in the first post-pandemic season 2010/11 (50.6%, 25.8%, and 41.0% vaccination coverage, respectively).ConclusionsSeasonal influenza vaccination coverage in Germany remains in all target groups below 75%, which is a declared goal of the European Union. Our results suggest that controversial public discussions about safety and the benefits of pandemic influenza vaccination may have contributed to both a very low uptake of pandemic vaccines and a decreased uptake of seasonal influenza vaccines in the first post-pandemic season. In the upcoming years, the uptake of seasonal influenza vaccines should be carefully monitored in all target groups to identify if this trend continues and to guide public health authorities in developing more effective vaccination and communication strategies for seasonal influenza vaccination.
Highlights
In Germany, annual vaccination against seasonal influenza is recommended for certain target groups (e.g. persons aged ≥60 years, chronically ill persons, healthcare workers (HCW))
In Germany, vaccination against seasonal influenza is recommended by the Standing Committee on Vaccination (STIKO) for individuals who have either an increased risk to develop severe influenza disease or who are likely to transmit the virus to vulnerable groups (e.g. health care workers (HCW)) [4]
The objectives of our study were (1) to assess seasonal influenza vaccination coverage for seasons 2008/09 to 2010/11, (2) to assess pandemic influenza vaccination coverage for season 2009/10, (3) to identify predictors of and barriers to pandemic vaccine uptake, and (4) to detect a potential influence of the pandemic situation on seasonal influenza vaccine uptake in the first post-pandemic season (2010/11)
Summary
In Germany, annual vaccination against seasonal influenza is recommended for certain target groups (e.g. persons aged ≥60 years, chronically ill persons, healthcare workers (HCW)). In season 2009/10, vaccination against pandemic influenza A(H1N1)pdm, which was controversially discussed in the public, was recommended for the whole population. Severe influenza virus infections or influenza-related complications typically occur in the very young and elderly population as well as in persons with underlying chronic medical conditions. In Germany, vaccination against seasonal influenza is recommended by the Standing Committee on Vaccination (STIKO) for individuals who have either an increased risk to develop severe influenza disease (i.e. persons aged ≥60 years, pregnant women, and persons with certain chronic medical conditions) or who are likely to transmit the virus to vulnerable groups (e.g. health care workers (HCW)) [4]. The AS03adjuvanted monovalent vaccine PandemrixW was almost exclusively used and available in sufficient quantities [7]
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