Skip to main content
Top
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Annual public health and economic benefits of seasonal influenza vaccination: a European estimate

Authors: Emmanuelle Preaud, Laure Durand, Bérengère Macabeo, Norbert Farkas, Brigitte Sloesen, Abraham Palache, Francis Shupo, Sandrine I Samson

Published in: BMC Public Health | Issue 1/2014

Login to get access

Abstract

Background

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. Moreover, vaccination coverage is below recommended levels.

Methods

A 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.

Results

Out 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.

Conclusions

Full 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.
Appendix
Available only for authorised users
Literature
1.
go back to reference World Health Organization: Vaccines against influenza WHO position paper – November 2012. Wkly Epidemiol Rec. 2012, 47: 461-476. World Health Organization: Vaccines against influenza WHO position paper – November 2012. Wkly Epidemiol Rec. 2012, 47: 461-476.
4.
go back to reference de MS Lopez-Cuadrado T, Jimenez-Jorge S, Savulescu C, Larrauri A: Influenza-related mortality in Spain, 1999–2005. Gac Sanit. 2012, 26: 325-329. 10.1016/j.gaceta.2011.09.033.CrossRef de MS Lopez-Cuadrado T, Jimenez-Jorge S, Savulescu C, Larrauri A: Influenza-related mortality in Spain, 1999–2005. Gac Sanit. 2012, 26: 325-329. 10.1016/j.gaceta.2011.09.033.CrossRef
5.
go back to reference Kyncl J, Prochazka B, Goddard NL, Havlickova M, Castkova J, Otavova M, Kriz B: A study of excess mortality during influenza epidemics in the Czech Republic, 1982–2000. Eur J Epidemiol. 2005, 20: 365-371. 10.1007/s10654-005-1067-y.CrossRefPubMed Kyncl J, Prochazka B, Goddard NL, Havlickova M, Castkova J, Otavova M, Kriz B: A study of excess mortality during influenza epidemics in the Czech Republic, 1982–2000. Eur J Epidemiol. 2005, 20: 365-371. 10.1007/s10654-005-1067-y.CrossRefPubMed
7.
go back to reference Ryan J, Zoellner Y, Gradl B, Palache B, Medema J: Establishing the health and economic impact of influenza vaccination within the European Union 25 countries. Vaccine. 2006, 24: 6812-6822.CrossRefPubMed Ryan J, Zoellner Y, Gradl B, Palache B, Medema J: Establishing the health and economic impact of influenza vaccination within the European Union 25 countries. Vaccine. 2006, 24: 6812-6822.CrossRefPubMed
9.
go back to reference World Health Organization: Review of the 2012-2013winter influenza season, northern hemisphere. Wkly Epidemiol Rec. 2013, 22: 225-232. World Health Organization: Review of the 2012-2013winter influenza season, northern hemisphere. Wkly Epidemiol Rec. 2013, 22: 225-232.
10.
go back to reference Groupe Regionaux d’Observation de la Grippe: Bilan de la saison grippale 2012–2013. 2013 Groupe Regionaux d’Observation de la Grippe: Bilan de la saison grippale 2012–2013. 2013
14.
go back to reference Bridges CB, Katz JM, Levandowski RA, Cox NJ: Inactivated influenza vaccines. Vaccines. Edited by: Plotkin SA, Orenstein WA, Offit PA. 2008, Philadelphia: Saunders Elsevier, 259-290. 5 Bridges CB, Katz JM, Levandowski RA, Cox NJ: Inactivated influenza vaccines. Vaccines. Edited by: Plotkin SA, Orenstein WA, Offit PA. 2008, Philadelphia: Saunders Elsevier, 259-290. 5
15.
go back to reference Nicoll A, Sprenger M: Low effectiveness undermines promotion of seasonal influenza vaccine. Lancet Infect Dis. 2013, 13: 7-9. 10.1016/S1473-3099(12)70313-4.CrossRefPubMed Nicoll A, Sprenger M: Low effectiveness undermines promotion of seasonal influenza vaccine. Lancet Infect Dis. 2013, 13: 7-9. 10.1016/S1473-3099(12)70313-4.CrossRefPubMed
23.
go back to reference Kroneman M, Van Essen GA, John PW: Influenza vaccination coverage and reasons to refrain among high-risk persons in four European countries. Vaccine. 2006, 24: 622-628.CrossRefPubMed Kroneman M, Van Essen GA, John PW: Influenza vaccination coverage and reasons to refrain among high-risk persons in four European countries. Vaccine. 2006, 24: 622-628.CrossRefPubMed
24.
go back to reference Mereckiene J, Cotter S, Nicoll A, Lévy-Bruhl D, Ferro A, Tridente G, Zanoni G, Berra P, Salmaso S, O’Flanagan D: National Seasonal Influenza Vaccination Survey in Europe, 2008. Euro Surveill. 2008, 13: 1-7. Mereckiene J, Cotter S, Nicoll A, Lévy-Bruhl D, Ferro A, Tridente G, Zanoni G, Berra P, Salmaso S, O’Flanagan D: National Seasonal Influenza Vaccination Survey in Europe, 2008. Euro Surveill. 2008, 13: 1-7.
25.
go back to reference Mereckiene J, Cotter S, Weber JT, Nicoll A, Lévy-Bruhl D, Ferro A, Tridente G, Zanoni G, Berra P, Salmaso S, O’Flanagan D: Low coverage of seasonal influenza vaccination in the elderly in many European countries. Euro Surveill. 2008, 13: 2-4. Mereckiene J, Cotter S, Weber JT, Nicoll A, Lévy-Bruhl D, Ferro A, Tridente G, Zanoni G, Berra P, Salmaso S, O’Flanagan D: Low coverage of seasonal influenza vaccination in the elderly in many European countries. Euro Surveill. 2008, 13: 2-4.
26.
go back to reference Blank PR, Schwenkglenks M, Szucs TD: Vaccination coverage rates in eleven European countries during two consecutive influenza seasons. J Infect. 2009, 58: 446-458. 10.1016/j.jinf.2009.04.001.CrossRefPubMed Blank PR, Schwenkglenks M, Szucs TD: Vaccination coverage rates in eleven European countries during two consecutive influenza seasons. J Infect. 2009, 58: 446-458. 10.1016/j.jinf.2009.04.001.CrossRefPubMed
27.
go back to reference Mereckiene J, Cotter S, D’Ancona F, Giambi C, Nicoll A, Levy-Bruhl D, Lopalco PL, Weber JT, Johansen K, Dematte L, Salmaso S, Stefanoff P, Greco D, Dorleans F, Polkowska A, O’Flanagan D: Differences in national influenza vaccination policies across the European Union, Norway and Iceland 2008–2009. Euro Surveill. 2010, 15: 11-20. Mereckiene J, Cotter S, D’Ancona F, Giambi C, Nicoll A, Levy-Bruhl D, Lopalco PL, Weber JT, Johansen K, Dematte L, Salmaso S, Stefanoff P, Greco D, Dorleans F, Polkowska A, O’Flanagan D: Differences in national influenza vaccination policies across the European Union, Norway and Iceland 2008–2009. Euro Surveill. 2010, 15: 11-20.
29.
go back to reference Emborg HD, Krause TG, Hviid A, Simonsen J, Molbak K: Effectiveness of vaccine against pandemic influenza A/H1N1 among people with underlying chronic diseases: cohort study, Denmark, 2009–10. BMJ. 2012, 344: d7901-CrossRef Emborg HD, Krause TG, Hviid A, Simonsen J, Molbak K: Effectiveness of vaccine against pandemic influenza A/H1N1 among people with underlying chronic diseases: cohort study, Denmark, 2009–10. BMJ. 2012, 344: d7901-CrossRef
30.
go back to reference Treanor JJ, Talbot HK, Ohmit SE, Coleman LA, Thompson MG, Chang PY, Petrie JG, Lofthus G, Meece JK, Williams JV, Berman L, Breece Hall C, Monto AS, Griffin MR, Belongia E, Shay DK, USFlu-VE, Network: Effectiveness of seasonal influenza vaccines in the United States during a season with circulation of all three vaccine strains. Clin Infect Dis. 2012, 55 (7): 951-959. 10.1093/cid/cis574.CrossRefPubMedPubMedCentral Treanor JJ, Talbot HK, Ohmit SE, Coleman LA, Thompson MG, Chang PY, Petrie JG, Lofthus G, Meece JK, Williams JV, Berman L, Breece Hall C, Monto AS, Griffin MR, Belongia E, Shay DK, USFlu-VE, Network: Effectiveness of seasonal influenza vaccines in the United States during a season with circulation of all three vaccine strains. Clin Infect Dis. 2012, 55 (7): 951-959. 10.1093/cid/cis574.CrossRefPubMedPubMedCentral
31.
go back to reference Kissling E, Valenciano M, Cohen JM, Oroszi B, Barret AS, Rizzo C, Stefanoff P, Nunes B, Pitigoi D, Larrauri A, Daviaud I, Horvath JK, O’Donnell J, Seyler T, Paradowska-Stankiewicz IA, Pechirra P, Ivanciuc AE, Jimenez-Jorge S, Savulescu C, Ciancio BC, Moren A: I-MOVE multicenter case control study 2010–2011: overall and stratified estimates of influenza vaccine effectiveness in Europe. PLoS One. 2011, 6: e27622-10.1371/journal.pone.0027622.CrossRefPubMedPubMedCentral Kissling E, Valenciano M, Cohen JM, Oroszi B, Barret AS, Rizzo C, Stefanoff P, Nunes B, Pitigoi D, Larrauri A, Daviaud I, Horvath JK, O’Donnell J, Seyler T, Paradowska-Stankiewicz IA, Pechirra P, Ivanciuc AE, Jimenez-Jorge S, Savulescu C, Ciancio BC, Moren A: I-MOVE multicenter case control study 2010–2011: overall and stratified estimates of influenza vaccine effectiveness in Europe. PLoS One. 2011, 6: e27622-10.1371/journal.pone.0027622.CrossRefPubMedPubMedCentral
32.
go back to reference Kissling E, Valenciano M, Larrauri A, Oroszi B, Cohen JM, Nunes B, Pitigoi D, Rizzo C, Rebolledo J, Paradowska-Stankiewicz I, Jimenez-Jorge S, Horvath JK, Daviaud I, Guiomar R, Necula G, Bella A, O’Donnell J, Gluchowska M, Ciancio BC, Nicoll A, Moren A: Low and decreasing vaccine effectiveness against influenza A(H3) in 2011/12 among vaccination target groups in europe: results from the i-move multicentre case–control study. Euro Surveill. 2013, 18 (5): 20390-PubMed Kissling E, Valenciano M, Larrauri A, Oroszi B, Cohen JM, Nunes B, Pitigoi D, Rizzo C, Rebolledo J, Paradowska-Stankiewicz I, Jimenez-Jorge S, Horvath JK, Daviaud I, Guiomar R, Necula G, Bella A, O’Donnell J, Gluchowska M, Ciancio BC, Nicoll A, Moren A: Low and decreasing vaccine effectiveness against influenza A(H3) in 2011/12 among vaccination target groups in europe: results from the i-move multicentre case–control study. Euro Surveill. 2013, 18 (5): 20390-PubMed
33.
go back to reference Jefferson T, Rivetti A, Di PC, Demicheli V, Ferroni E: Vaccines for preventing influenza in healthy children. Cochrane Database Syst Rev. 2012, 8: CD004879-PubMed Jefferson T, Rivetti A, Di PC, Demicheli V, Ferroni E: Vaccines for preventing influenza in healthy children. Cochrane Database Syst Rev. 2012, 8: CD004879-PubMed
34.
go back to reference Jefferson T, Di PC, Rivetti A, Bawazeer GA, Al-Ansary LA, Ferroni E: Vaccines for preventing influenza in healthy adults. Cochrane Database Syst Rev. 2010, 7: CD001269-PubMed Jefferson T, Di PC, Rivetti A, Bawazeer GA, Al-Ansary LA, Ferroni E: Vaccines for preventing influenza in healthy adults. Cochrane Database Syst Rev. 2010, 7: CD001269-PubMed
35.
go back to reference Jefferson T, Di PC, Al-Ansary LA, Ferroni E, Thorning S, Thomas RE: Vaccines for preventing influenza in the elderly. Cochrane Database Syst Rev. 2010, 2: CD004876-PubMed Jefferson T, Di PC, Al-Ansary LA, Ferroni E, Thorning S, Thomas RE: Vaccines for preventing influenza in the elderly. Cochrane Database Syst Rev. 2010, 2: CD004876-PubMed
36.
go back to reference Pitman RJ, Melegaro A, Gelb D, Siddiqui MR, Gay NJ, Edmunds WJ: Assessing the burden of influenza and other respiratory infections in England and Wales. J Infect. 2007, 54: 530-538. 10.1016/j.jinf.2006.09.017.CrossRefPubMed Pitman RJ, Melegaro A, Gelb D, Siddiqui MR, Gay NJ, Edmunds WJ: Assessing the burden of influenza and other respiratory infections in England and Wales. J Infect. 2007, 54: 530-538. 10.1016/j.jinf.2006.09.017.CrossRefPubMed
37.
go back to reference Jansen AG, Sanders EA, Hoes AW, van Loon AM, Hak E: Influenza- and respiratory syncytial virus-associated mortality and hospitalisations. Eur Respir J. 2007, 30: 1158-1166. 10.1183/09031936.00034407.CrossRefPubMed Jansen AG, Sanders EA, Hoes AW, van Loon AM, Hak E: Influenza- and respiratory syncytial virus-associated mortality and hospitalisations. Eur Respir J. 2007, 30: 1158-1166. 10.1183/09031936.00034407.CrossRefPubMed
38.
go back to reference Zucs P, Buchholz U, Haas W, Uphoff H: Influenza associated excess mortality in Germany, 1985–2001. Emerg Themes Epidemiol. 2005, 2: 6-10.1186/1742-7622-2-6.CrossRefPubMedPubMedCentral Zucs P, Buchholz U, Haas W, Uphoff H: Influenza associated excess mortality in Germany, 1985–2001. Emerg Themes Epidemiol. 2005, 2: 6-10.1186/1742-7622-2-6.CrossRefPubMedPubMedCentral
39.
go back to reference Rizzo C, Bella A, Viboud C, Simonsen L, Miller MA, Rota MC, Salmasao S, Ciofi degli Atti ML: Trends for influenza-related deaths during pandemic and epidemic seasons, Italy, 1969–2001. Emerg Infect Dis. 2007, 13 (5): 694-699. 10.3201/eid1305.061309.CrossRefPubMedPubMedCentral Rizzo C, Bella A, Viboud C, Simonsen L, Miller MA, Rota MC, Salmasao S, Ciofi degli Atti ML: Trends for influenza-related deaths during pandemic and epidemic seasons, Italy, 1969–2001. Emerg Infect Dis. 2007, 13 (5): 694-699. 10.3201/eid1305.061309.CrossRefPubMedPubMedCentral
40.
go back to reference Health Protection Agency (UK): Surveillance of influenza and other respiratory viruses in the UK, 2010/2011. 2011 Health Protection Agency (UK): Surveillance of influenza and other respiratory viruses in the UK, 2010/2011. 2011
41.
go back to reference Gran JM, Iversen B, Hungnes O, Aalen OO: Estimating influenza-related excess mortality and reproduction numbers for seasonal influenza in Norway, 1975–2004. Epidemiol Infect. 2010, 138: 1559-1568. 10.1017/S0950268810000671.CrossRefPubMed Gran JM, Iversen B, Hungnes O, Aalen OO: Estimating influenza-related excess mortality and reproduction numbers for seasonal influenza in Norway, 1975–2004. Epidemiol Infect. 2010, 138: 1559-1568. 10.1017/S0950268810000671.CrossRefPubMed
42.
go back to reference Carrat F, Sahler C, Rogez S, Leruez-Ville M, Freymuth F, Le Gales C, Bungener M, Housset B, Nicolas M, Rouzioux C: Influenza burden of illness: estimates from a national prospective survey of household contacts in France. Arch Intern Med. 2002, 162: 1842-1848. 10.1001/archinte.162.16.1842.CrossRefPubMed Carrat F, Sahler C, Rogez S, Leruez-Ville M, Freymuth F, Le Gales C, Bungener M, Housset B, Nicolas M, Rouzioux C: Influenza burden of illness: estimates from a national prospective survey of household contacts in France. Arch Intern Med. 2002, 162: 1842-1848. 10.1001/archinte.162.16.1842.CrossRefPubMed
43.
go back to reference Galante M, Garin O, Sicuri E, Cots F, Garcia-Altes A, Ferrer M, Dominguez A, Alonso J: Health services utilization, work absenteeism and costs of pandemic influenza A (H1N1) 2009 in Spain: a multicenter-longitudinal study. PLoS One. 2012, 7 (2): e31696-10.1371/journal.pone.0031696.CrossRefPubMedPubMedCentral Galante M, Garin O, Sicuri E, Cots F, Garcia-Altes A, Ferrer M, Dominguez A, Alonso J: Health services utilization, work absenteeism and costs of pandemic influenza A (H1N1) 2009 in Spain: a multicenter-longitudinal study. PLoS One. 2012, 7 (2): e31696-10.1371/journal.pone.0031696.CrossRefPubMedPubMedCentral
46.
go back to reference Garin O, Galante M, García-Altés A, Sicuri E, Cots F, Nebot M, Ferrer M, Dominguez A, Alonso J: Use of Services and Costs of Patients With Flu (H1N1) 2009 In Spain: Background and Research Protocol (In Spanish). Rev Esp Salud Publica. 2011, 85: 19-31.PubMed Garin O, Galante M, García-Altés A, Sicuri E, Cots F, Nebot M, Ferrer M, Dominguez A, Alonso J: Use of Services and Costs of Patients With Flu (H1N1) 2009 In Spain: Background and Research Protocol (In Spanish). Rev Esp Salud Publica. 2011, 85: 19-31.PubMed
49.
go back to reference Jahnz-Rozyk K: Costs of Treating Infections caused by breathing viruses and pneumonia in the elderly population in Poland (In Polish). 2012 Jahnz-Rozyk K: Costs of Treating Infections caused by breathing viruses and pneumonia in the elderly population in Poland (In Polish). 2012
50.
go back to reference Brydak L, Roiz J, Faivre P, Reygrobellet C: Implementing an influenza vaccination programme for adults aged >/=65 years in Poland: a cost-effectiveness analysis. Clin Drug Investig. 2012, 32: 73-85. 10.2165/11594030-000000000-00000.CrossRefPubMed Brydak L, Roiz J, Faivre P, Reygrobellet C: Implementing an influenza vaccination programme for adults aged >/=65 years in Poland: a cost-effectiveness analysis. Clin Drug Investig. 2012, 32: 73-85. 10.2165/11594030-000000000-00000.CrossRefPubMed
51.
go back to reference Anell A, Glenngard AH, Merkur S: Sweden health system review. Health Syst Transit. 2012, 14: 1-159.PubMed Anell A, Glenngard AH, Merkur S: Sweden health system review. Health Syst Transit. 2012, 14: 1-159.PubMed
52.
go back to reference Pitman RJ, Nagy LD, Sculpher MJ: Cost-effectiveness of childhood influenza vaccination in England and Wales: Results from a dynamic transmission model. Vaccine. 2013, 31 (6): 927-942. 10.1016/j.vaccine.2012.12.010.CrossRefPubMed Pitman RJ, Nagy LD, Sculpher MJ: Cost-effectiveness of childhood influenza vaccination in England and Wales: Results from a dynamic transmission model. Vaccine. 2013, 31 (6): 927-942. 10.1016/j.vaccine.2012.12.010.CrossRefPubMed
53.
go back to reference Maciosek MV, Solberg LI, Coffield AB, Edwards NM, Goodman MJ: Influenza vaccination health impact and cost effectiveness among adults aged 50 to 64 and 65 and older. Am J Prev Med. 2006, 31: 72-79. 10.1016/j.amepre.2006.03.008.CrossRefPubMed Maciosek MV, Solberg LI, Coffield AB, Edwards NM, Goodman MJ: Influenza vaccination health impact and cost effectiveness among adults aged 50 to 64 and 65 and older. Am J Prev Med. 2006, 31: 72-79. 10.1016/j.amepre.2006.03.008.CrossRefPubMed
54.
go back to reference Kostova D, Reed C, Finelli L, Cheng P-Y, Gargiullo PM, Shay DK, Singleton JA, Meltzer MI, Lu P, Bresee JS: Influenza Illness and Hospitalizations Averted by Influenza Vaccination in the United States, 2005–2011. PLoS One. 2013, 8 (6): e66312-10.1371/journal.pone.0066312.CrossRefPubMedPubMedCentral Kostova D, Reed C, Finelli L, Cheng P-Y, Gargiullo PM, Shay DK, Singleton JA, Meltzer MI, Lu P, Bresee JS: Influenza Illness and Hospitalizations Averted by Influenza Vaccination in the United States, 2005–2011. PLoS One. 2013, 8 (6): e66312-10.1371/journal.pone.0066312.CrossRefPubMedPubMedCentral
55.
go back to reference Blank PR, Schwenkglenks M, Szucs T: The impact of European vaccination policies on seasonal influenza vaccination coverage rates in the elderly. Hum Vaccin Immunother. 2012, 8: 328-335. 10.4161/hv.18629.CrossRefPubMed Blank PR, Schwenkglenks M, Szucs T: The impact of European vaccination policies on seasonal influenza vaccination coverage rates in the elderly. Hum Vaccin Immunother. 2012, 8: 328-335. 10.4161/hv.18629.CrossRefPubMed
Metadata
Title
Annual public health and economic benefits of seasonal influenza vaccination: a European estimate
Authors
Emmanuelle Preaud
Laure Durand
Bérengère Macabeo
Norbert Farkas
Brigitte Sloesen
Abraham Palache
Francis Shupo
Sandrine I Samson
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-813

Other articles of this Issue 1/2014

BMC Public Health 1/2014 Go to the issue