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Comparative Study
. 2012 Aug;22(4):562-8.
doi: 10.1093/eurpub/ckr094. Epub 2011 Jul 12.

Influenza vaccination coverage among high-risk groups in 11 European countries

Adrian Loerbroks  1 , Christian Stock, Jos A Bosch, David G Litaker, Christian J Apfelbacher
Affiliations
Comparative Study

Influenza vaccination coverage among high-risk groups in 11 European countries

Adrian Loerbroks et al. Eur J Public Health. 2012 Aug.

Abstract

Background: National vaccination coverage rates for individuals at increased risk of influenza-related complications represent a useful public health indicator of preparedness. We compared European countries regarding (i) vaccination coverage among high-risk groups and (ii) the likelihood that high-risk individuals reported influenza vaccination compared with those at lower risk.

Methods: We used data from the Survey of Health, Ageing and Retirement in Europe (SHARE) collected in 2004-05. Adults aged ≥ 50 years from 11 countries provided self-reports of an influenza vaccination in the previous year (n = 16,913). We defined four high-risk groups (age ≥ 65 years, presence of vascular disease, chronic lung disease or diabetes) and calculated vaccination coverage with 95% confidence intervals for each country. Country-specific multivariable logistic regression was used to estimate odds ratios (ORs) for membership in a high-risk group and vaccination.

Results: The Netherlands had the highest influenza vaccination coverage in high-risk groups (≥ 75% in any group) while Greece had the lowest (<27% in any group). Older age was positively associated with report of vaccination in all countries, but the strength of this association varied from an OR of <2 (Germany) to >13 (The Netherlands). The ORs for the chronic disease groups was ≥ 4 for The Netherlands and were considerably lower (and often not statistically significant) for the other countries.

Conclusion: Influenza vaccination coverage among high-risk groups varies considerably between European countries. Our findings highlight potential opportunities for reducing influenza-related complications through support for vaccination programs that target high-risk individuals more effectively.

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Figures

Figure 1
Figure 1
Prevalence of influenza vaccination and corresponding 95% confidence intervals by country and high-risk group
Figure 2
Figure 2
Multivariable odds ratios (ORs) and 95% confidence intervals for the association between high-risk group membership and influenza vaccination, by country. (A) Older age (≥65 years vs 50–64 years) and vaccination; (B) Vascular disease (yes vs no) and vaccination; (C) Chronic lung disease (yes vs no) and vaccination; (D) Diabetes (yes vs no) and vaccination. ORs are adjusted for high-risk group membership, sex, income, education and the number of annual contacts with physicians
Figure 2
Figure 2
Multivariable odds ratios (ORs) and 95% confidence intervals for the association between high-risk group membership and influenza vaccination, by country. (A) Older age (≥65 years vs 50–64 years) and vaccination; (B) Vascular disease (yes vs no) and vaccination; (C) Chronic lung disease (yes vs no) and vaccination; (D) Diabetes (yes vs no) and vaccination. ORs are adjusted for high-risk group membership, sex, income, education and the number of annual contacts with physicians
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