Transcript Document

Seasonal Influenza
Vaccination in Europe
2007/8 Coverage Rates in 11 European
Countries
THOMAS SZUCS
Institute of Social- and Preventive Medicine
University of Zurich
1
Overview
•
•
•
•
•
Study objectives
Methodology
Vaccination recommendations
Key findings
Motivations and barriers for
vaccination
• Lessons learned
2
Study Objectives
To analyse and determine:
• Influenza vaccination coverage rates (2007/8) in 11
European countries
• Understand motivations and barriers for vaccination
• Identify approaches to improve vaccination coverage
• Compare vaccination
previous year
levels
and
intentions
with
3
Methodology
• A sample of 22,000 (approximately 2000 individuals per
country), representative of the adult population aged 14
and over
• 9 countries with similar questionnaires: Austria, Czech
Republic, Finland, Germany, Ireland, Italy, Portugal, Spain
and UK
• Community-based
survey
via
computer-assisted
telephone interviews (conducted by TNS healthcare)
• French data collected via a postal questionnaire by GEIG
(Groupe d’Etude et d’Information sur la Grippe)
• Polish data collected via a face-to-face questionnaire
4
Methodology
• Focus on populations recommended for vaccination
• Quantitative data is shown per country; qualitative
data is aggregated across all countries
• Polish data is shown for 2007/8 only due to a
methodology change
• Publication for full data set is in preparation
5
Influenza vaccination recommendations
in Europe and WHO coverage objectives
Vaccination recommendations
• Age-based: all people above a defined age-limit
– Generally from 65 years of age upwards
• Risk-based: all people under the age-defined limit suffering from
underlying/chronic illnesses
– People with cardiovascular, respiratory, metabolic and/or renal disease & the
immuno-compromised
• Health care workers*
Vaccination coverage rate objectives
• As determined by the World Health Organisation for the elderly**
– 50% by 2006
– 75% by 2010
• And supported by the European Parliament***
*Recommended in a number of EU countries
**WHA resolution 56.19 – 28 May 2003
***European Parliament resolution [P6_TA(2005)0406] on the strategy against an influenza pandemic, 26 October 2005
6
Key Findings:
Elderly (≥65 years)
7
Influenza vaccination rates for the elderly
(≥65 years) differ widely across Europe
2007/8 influenza vaccination rate (%)
100
90
80
78
69
70
67
65
61
60
60
54
51
50
37
40
32
30
16
20
10
0
UK
France
Spain
Ireland
Germany
(392)
(402)
(246)
(266)
(495)
Italy
(348)
Finland
(312)
Portugal
(312)
Austria
(394)
Czech
Republic
(325)
Poland
(327)
8
Few countries meet the WHO target level
2007/8 influenza vaccination rate (%)
100
90
80
78
WHO 2010 target = 75%
69
70
67
65
61
60
60
54
51
50
37
40
32
30
16
20
10
0
UK
France
Spain
Ireland
Germany
(392)
(402)
(246)
(266)
(495)
Italy
(348)
Finland
(312)
Portugal
(312)
Austria
(394)
Czech
Republic
(325)
Poland
(327)
9
There was little improvement on last year
(2006/7)
100
2006/7
Influenza vaccination rate (%)
90
2007/8
78
80
70
68 69
70
71
WHO 2010 target = 75%
67
66
63 65
60
61
60
53
51
54
53 51
50
37 37
40
30 32
30
16
20
10
0
UK
France
(384) (392) (400) (402)
Spain
Ireland
Germany
Italy
Finland
Portugal
Austria
(246) (246)
(241) (266)
(481) (495)
(348) (348)
(299) (312)
(384) (400)
(419) (394)
Czech
Republic
(326) (325)
Poland
(-) (327)
10
Key Findings:
<65 years at risk
11
Vaccination rates for <65s at risk are
considerably lower than the WHO elderly
target
2007/8 influenza vaccination rate (%)
100
90
WHO 2010 elderly target = 75%
80
70
60
54
50
42
41
40
38
33
28
30
26
24
19
20
19
11
10
0
UK
(186)
Italy
Spain
France
(127)
(214)
(198)
Portugal
Germany
Ireland
Finland
Austria
Czech
Republic
Poland
(234)
(284)
(150)
(331)
(165)
(232)
(319)
12
…again, with little or no improvement on
Influenza vaccination rate (%)
last year
100
2006/7
90
2007/8
80
WHO 2010 elderly target = 75%
70
60
5654
47
50
42
40
41
37
38
35
39
3433
2828
30
26
20
24
17
24
19
1719
11
10
0
UK
Italy
Spain
(176) (186)
(166) (127)
(186) (214)
France
(204) (198)
Portugal Germany
(185) (234)
(287) (284)
Ireland
Finland
(130) (150)
(332) (331)
Austria
(159) (165)
Czech
Republic
Poland
(247) (232)
(-) (319)
13
Key Findings:
Healthcare professionals
14
Coverage rates for healthcare professionals
are very low
2007/8 influenza vaccination rate (%)
100
90
80
WHO 2010 elderly target = 75%
70
60
50
40
30
29
28
28
26
24
23
22
21
20
20
17
9
10
0
UK
(171)
Czech
Portugal
Republic
(101)
(75)
Spain
France
(133)
(121)
Germany
(170)
Austria
Finland
Ireland
(184)
(135)
(174)
Italy
(75)
Poland
(60)
15
Rates remain at levels similar to last year
100
2006/7
Influenza vaccination rate (%)
90
2007/8
WHO 2010 elderly target = 75%
80
70
60
50
40
29
30
24
20
28
25
28
24 26
25 24
22 23
22
17
20
21
22 20
13
16 17
9
10
0
UK
Czech
Republic
(130) (171) (106) (101)
Portugal
Spain
France
Germany
Austria
Finland
Ireland
Italy
(74) (75)
(98) (133)
(134) (121)
(170) (170)
(205) (184)
(162) (135)
(141) (174)
(84) (75)
Poland
(-) (60)
16
Key Findings:
Intention to get vaccinated
versus actual vaccination
17
Intentions tend to be higher than actual
vaccination for the elderly (≥65 years)…
100
Intentions for 2007/8
Influenza vaccination rate (%)
90
80
2007/8
75
78
75
70
70
69
WHO 2010 target = 75%
73
67
65
61 61
65
60
60
57
54
57
51
50
47
42
37
40
32
30
16
20
10
0
UK
(384) (392) (384)
France
(400) (402) (400)
Spain
(246) (246) (246)
Ireland
Germany
(241) (266) (241)
(481) (495) (481)
Italy
Finland
(348) (348) (348)
Portugal
(299) (312) (299)
Austria
(384) (400) (384)
Czech
Republic
(419) (394) (419)
Poland
(326) (325) (326)
(-) (327) (-)
18
…but the gap is even greater for <65s at risk
100
Intentions for 2007/8
Influenza vaccination rate (%)
90
2007/8
WHO 2010 elderly target = 75%
80
70
60
68
63
54
50
43 42
48
46
41
40
41
43
39
38
37
33
28
30
26
24 24
19
20
19
11
10
0
UK
Italy
(176) (186) (176) (166) (127) (166)
Spain
(186) (214) (186)
France
Portugal
(204) (198) 204)
Germany
(185) (234) (185)
Ireland
(287) (284) (287)
Finland
(130) (150) (130)
Austria
(332) (331) (332)
Czech
Republic
(159) (165) (159)
Poland
(247) (232) (247)
(-) (319) (-)
19
Key Findings:
Motivations and barriers to
vaccination
20
Lack of funding correlates with
dramatically lower vaccination rates
2007/8 influenza vaccination rate (%)
100
90
80
78
WHO 2010 target = 75%
69
70
60
67
65
61
60
54
54
50
38
40
Little or no funding /
reimbursement
51
42
41
33
26
30
28
37
32
24
19
20
19
16
11
10
0
UK
(392)
France
Spain
Ireland
(402)
(246)
(266)
Germany
(495)
Elderly
Italy
(348)
Finland
(312)
Portugal
(312)
Austria
(394)
Czech
Republic
(325)
Poland
(327)
<65 at risk
21
Several key factors encouraged vaccination…
%
100
90
1. Pro-active
HCW
3. Adequate
funding in place
2. Education on the seriousness of
the disease and role of vaccination
80
70
64
63
59
56
60
49
50
51
40
40
33
31
26
30
20
10
fo
ri
pa
y
ec
ur
it y
lS
oc
ia
fre
e/
S
s
It'
in
So
Id
on
't p
as
s
us
se
r io
is
en
za
In
flu
t
en
ds
/fr
i
fa
m
ily
flu
en
za
Id
id
&
do
ct
or
(
ily
fa
m
y
M
to
no
tw
nu
rs
e)
ad
vis
ed
an
tt
o
m
e
ge
t
it
to
0
<65 yrs at risk (705)
65 yrs + (2103)
22
…and would encourage future vaccination in
all recommended groups…
100
1. Pro- active
HCW
90
2. Education on the vaccine and
disease
3. Adequate
funding of
vaccination
29
28
80
70
56
60
60
50
40
30
26
22
21
20
21
20
10
M
or
e
ed
bu
rs
ch
ea
pe
ro
rr
eim
to
ler
a
er
e
If
it w
M
or
e
in
fo
rm
at
io
n
in
fo
rm
on
at
io
n
on
va
cc
in
e
th
e
va
cc
in
e
on
at
io
n
in
fo
rm
or
e
M
di
se
as
e
ef
fic
ac
y
it
m
en
de
d
ec
om
e)
r
nu
rs
do
ct
or
(
If
m
y
nc
e
0
<65 yrs at risk (2440)
65 yrs+ (3906)
23
…as would lifestyle factors
100
90
80
1. Proactive
HCW
4. Lifestyle
factors
3. Adequate
funding of
vaccination
2. Education on the vaccine and
disease
70
60
56
60
50
40
30
29
22
28
26
20
21
25
21
25
20
20
10
<65 yrs at risk (2440)
65 yrs+ (3906)
at
cin
Va
c
Tr
av
el
to
hi
gh
ris
k
in
fl u
en
za
io
n
at
re
g
io
n
wo
r
s
k
0
24
Lessons learned
• Influenza vaccine coverage has not improved in
recommended groups since last year
– Elderly coverage does not meet the WHO objective yet in the vast
majority of countries surveyed
– Coverage of at-risk under 65s continues to be much lower than in the
elderly
– Coverage amongst healthcare workers is extremely low
– All groups have positive intentions but these do not translate into actual
coverage
25
Improving coverage in major target
groups
• Several factors would encourage vaccination and break
down barriers to immunization:
1. Healthcare professionals should proactively recommend vaccination to
at-risk patients and introduce ‘reminder’ systems
2. Broad & effective communication campaigns should educate the public
on influenza and influenza vaccines
3. Healthcare systems should enable free / reimbursed vaccination
4. Life style factors should be considered such as making vaccination
available in alternative settings (at work etc)
26
Acknowledgments
• TNS Healthcare
• Study participants
• The European Vaccine Manufacturers group which
supported the study via an educational grant
27