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First-time analysis reveals millions of Europeans left at risk from influenza

Powerful tool highlights need to implement EU recommendations for increased influenza vaccination

A powerful analysis from this month's Vaccine 1 highlights the huge gap between current vaccination coverage across Europe and the recommendations endorsed by the European Union. Currently, only one third (35%) of all high risk populations are receiving seasonal influenza vaccine in Europe, resulting in avoidable morbidity, hospitalisations and mortality.

For the first time, researchers have attempted to develop a model to enable European public health officials to visualise the need for better influenza control and implement the World Health Organization's (WHO) recommendations for vaccination coverage. The model highlights the consequences of low vaccine coverage, including preventable death, and demonstrates that the cost of increased vaccination could be offset by the reduced demand on healthcare services.

"This valuable model shows there is a lost opportunity in Europe right now to protect the health of people at risk across the EU. The real societal burden of influenza epidemics is often underestimated, and there is needless suffering and deaths that could be prevented by increasing the rate of vaccination to include all people at risk of influenza. Our hope is that this model will demonstrate the public health implications of influenza and focus both governments and vaccine suppliers to address the underutilization of influenza vaccines," said Dr Albert Osterhaus, Chairman of the European Scientific Working Group on Influenza (ESWI).

The gap between current influenza vaccine use and the population who could benefit has important implications for global influenza pandemic preparedness. In 2003, the World Health Assembly resolved to aim for at least 50% of the elderly population to receive annual seasonal vaccines by 2006, and 75% by 2010. In October 2006, the WHO followed this with a call to all countries preparing for a pandemic to increase use of seasonal influenza vaccines 2 to help increase vaccine production capacity in preparation for a pandemic and to reduce the likelihood of a pandemic strain developing in the first place.

"This analysis confirms around half a million people are dying unnecessarily from influenza each year and many more are needlessly put at risk. Increasing vaccination rates in Europe would accomplish two important tasks. It would dramatically reduce the number of cases of death and illness from influenza, and contribute to flu pandemic preparedness in Europe by increasing vaccine production and distribution capacity," continued Dr Osterhaus.

Influenza experts from Solvay Pharmaceuticals in collaboration with a research team at Mapi Values in the UK, took on this project in response to a World Health Assembly resolution issued in 2003 in an effort to help establish the health and economic impact of influenza vaccination within the European Union 25 Countries.

"At Solvay Pharmaceuticals we are exploring every avenue to increase vaccine capacity and are making significant investments to increase vaccine supply using pioneering cell-culture manufacturing technologies that do not rely on conventional egg based vaccine production," commented Dr Bram Palache, study author and member of Solvay Pharmaceuticals Influenza Pandemic Preparedness team.

"Production capacity for influenza vaccines is currently insufficient for pandemic preparedness. As a key player in the influenza vaccine industry we believe that pre-pandemic vaccines stockpiled may be one real way of offering adequate levels of immunity and protection to face up to the real challenges of a future influenza pandemic," concluded Dr Palache.

Research Results – Visualising The Gap

For the EU-25, it was estimated that up to a half (49.1%) of the population (223.4 million people) should be vaccinated against influenza, ranging from 56.4% in the UK to 41.6% in Cyprus.

There were on average of 174 vaccine doses distributed per 1000 population within the EU-25, which leads to an average vaccination rate of the target population of 35.4% based on current supply constraints

As a consequence up to 144.4 million people who are considered "at risk" may not be vaccinated.

Implementing a 100% vaccination rate programme for all risk groups across the EU-25 would lead to an estimated reduction of number of influenza cases of 7.22 million, 1.96 million reduced primary care physician visits for influenza treatment, 796,743 less hospital admissions and 68,537 fewer influenza related deaths for all EU-25 countries

Implementing a 100% vaccination rate programme for all risk groups in France, Germany, Italy, Spain and UK would require an additional 1.52 billion Euro but this would result in an estimated savings of 39.45 million Euro of reduced primary care visits and a further saving of 1.59 billion Euro in reduced hospitalisations.

"This analysis confirms that increasing vaccination rates is fully justified through a cost-benefit analysis. This model is a clear call to action for visualising our vaccination goals. I cannot stress enough the urgency of action for public health officials and governments across Europe to address this issue today and prepare for a pandemic tomorrow," concluded Dr Osterhaus.

Linda Munro | EurekAlert!
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