Perspectives from regions: successes and challenges in promoting seasonal influenza vaccine usage in the EU

Transcription

1 Perspectives from regions: successes and challenges in promoting seasonal influenza vaccine usage in the EU N. Safrany European Commission Pr. A. Nicoll ECDC 2 nd WHO GAP mtg July 2011

2 Background - Burden of seasonal influenza in the EU Severe disease that may be fatal excess mortality for each season in EU: up to Disease associated costs direct use of medical resources indirect work absenteeism productivity loss Annual costs between 6 27bn Increasing importance of influenza vaccination aging population more people living well with chronic conditions And yet EU vaccination coverage in the EU is low

3 Vaccination coverage for seasonal influenza vaccine in older people (65 years & older) in EU and EEA countries Latest seasonal data available in spring For season 2006/7 Data not available for: Bulgaria,Cyprus, Estonia, Greece, Iceland, Latvia, Malta Data from VENICE survey and other sources, version 18 March Available from:

4 Vaccination coverage for seasonal influenza vaccine in older people (65 years & older) in EU and EEA countries Latest seasonal data available in spring For season 2007/8 Data available in No data available from: Austria, Cyprus, Czech Republic, Greece, Latvia Data from VENICE survey and other sources, version November Available from and

5 Pandemic 2009 Vaccination coverage in entire population (n=21 countries) Sweden Finland Iceland Norway The Netherlands Spain Hungary Ireland Malta Romania Germany France Luxemburg Portugal Slovenia Italy Estonia Greece Cyprus Austria Czech Republic Vaccination coverage % Preliminary results

6 Challenges From the virus 2010/2011 dominated by pandemic strain and B viruses Risk groups may have changed Example of new burden from the UK ARDS was a pblm in ICU-s.

7 Challenges In delivery Different policy approaches State funded or subsidised Insurance funded Infl. immunisation integrated into routine immunisation systems

8 Eurosurveillance, Volume 13, Issue 43, 23 October 2008 National Seasonal Influenza Vaccination Survey in Europe, 2008, J Mereckiene et al

9 Challenges In delivery Different policy approaches State funded or subsidised Insurance funded Infl. immunisation integrated into routine immunisation systems Priority groups: All countries recommend vaccination of the elderly however age specified differs 17 countries: 65 and olders 5 countries: 60 and olders 2 countries: over 55 2 countries over 50

10 Underlying/medical conditions for which influenza immunisation is recommended without regard to age: national seasonal influenza vaccination survey in Europe, July 2009 Eurosurveillance, November 2010, Difference in national influenza vaccination policies across the EU, NO and Iceland, 08-09, J. Mereckiene et al.

11 Challenges In delivery Communication Lack of awareness of influenza Lack of education on the disease Lack of trust towards authorities Lack of adequate advice New media Doubts on vaccine safety & effectiveness Involvement of healthcare workers Zurich University 79% of people likely to be vaccinated if recommended by healthcare provider

12 Successes 2009 Council Recommendation on seasonal influenza vaccination Background 2003 WHA Resolution Objective mitigate the impact of seasonal influenza encourage vaccination among risk groups Target By 2014/ Reach coverage rate of 75% in older age groups and other risk groups Means Member Sates to implement, taking into account ECDC guidance, national action plans Improve vaccination coverage Organise annual uptake survey in all risk groups Foster education, training and information exchange For healthcare workers Risk groups and their families

13 Joint Procurement Pandemic infl. Vaccines Background Lessons learned from the 2009 Pandemic Objective A mechanism enabling common acquisition for participating countries strengthen solidarity btwn Member States by ensuring a more equitable access to vaccines Expected added value Stronger purchasing power Transparency and pooling of expertise Solidarity btwn Member States Better pandemic preparedness More synchronised start of the vaccination campaigns More favourable public opinion

14 Enactment ECDC to Map key activities contributing to the implementation Develop a monitoring framework Develop guidance document on core indicators Technical assistance to Member States in the collection of data Produce an interim report based on influenza season

15 Ten ECDC Contributions 1. Scientific advice - who should be immunised? Pallas Project New groups? Children Pregnant women 2. Surveillance including severe disease and integrated epidemiology & virology EISN network 3. Monitoring Member State Policies & Coverage VENICE Programme (covers all vaccinations) 4. Evaluating Vaccine Effectiveness I MOVE Project with Epiconcept and Member States 5. Investigating Vaccine Safety Issues VAESCO Project & Database Linkage

16 Ten ECDC Contributions 6. Estimating the Burden of Disease 7. Monitoring and Evaluation of Progress Developing a package with member states Scoping what the needs are 8. Developing Training Packages 9. Promoting Vaccination - Communication and Investigating Behavioural Aspects Updating Communication Tool Kit Annual Spotlights Developing an evidence based approach to behavioural interventions 10.Fortnightly Digest of Scientific & Public Health Development

17 Conclusions Vaccination coverage remains low and below our targets Important challenges Communication Doubts on vaccine safety & effectiveness Need to engage with stakeholders, notably HCW However EU Commitment to mitigate the impact of seasonal influenza encourage vaccination among risk groups Foster education, training and communication