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.
Notes to editors
For an interview with study author Dr Bram Palache, Global Director Scientific Communications and Public Affairs, Solvay Pharmaceuticals please call: +44 (0)207 611 3629.
Dr Palache earned a Master of Science degree in Biochemistry from the University of Amsterdam in 1980. Upon graduation, he began his professional career as a Clinical Research Associate at Solvay Pharmaceuticals in the Netherlands. This role provided Dr Palache with a wealth of background and experience in the clinical development of new drugs in various fields. Throughout his career at Solvay Pharmaceuticals, he has held a variety of clinical leadership roles. Currently he is serving as the director for the clinical development program of Solvay Pharmaceutical's new cell-cultured influenza vaccine using Madine Darby Canine Kidney (MDCK) cells, which was registered in 2001 in the Netherlands.
Dr Palache received his PhD in 1991 from Erasmus University in Rotterdam, the Netherlands, and continued at the university as an Influenza Research Fellow at the Dutch National Influenza Centre.
He has been on the Executive Committee of the European Scientific Working Group on Influenza (ESWI) since 1993, a member of the Clinical and Public Health Working Groups of the Association of the European Vaccine Manufacturers (EVM) since 2001, and a member of the EVM Pandemic Working Group since 2005.
Dr Palache helped to establish the Influenza Vaccine Supply International Task Force (IVS) in 2003, and he has chaired the Policy Practice and Communication subgroup (PPC) of the IVS since 2004. In 2006 he became the Solvay Pharmaceutical's representative on the Asia Pacific Advisory Committee Influenza group.
Dr Palache is author of over 40 papers, most of which were published in peer-reviewed medical scientific journals. He is co-author of the Influenza Rapid Reference book, which was published by Elsevier in 2006.
Background
In 2003 the World Health Assembly (WHA) expressed concern over the general lack of national and global awareness for a future influenza pandemic and therefore issued a resolution urging the 25 European Union Member States to
- Establish and implement strategies to increase vaccination coverage of all people at high risk, including the elderly and people with underlying disease, with the goal of attaining vaccination coverage of the elderly population of at least 50% by 2006 and 75% by 2010.
Assess disease burden and economic impact of annual influenza epidemics as a basis for framing and implementing influenza prevention policies.
To draw up and implement national plans for pandemic preparedness
To contribute to heightened preparedness for influenza epidemics and pandemics through national surveillance
To support the research and development on improved influenza vaccines.
This resolution was reinforced by the European Union where Member States agreed to make additional efforts to improve uptake on their territory in accordance with their own recommendations and to achieve the World Health Organisation target of 75% in high risk groups before 2010.
About Solvay Pharmaceuticals
Solvay Pharmaceuticals is a research-based pharmaceutical company, active in the therapeutic areas of cardiology (cardio metabolic), neuroscience, influenza vaccine and a select group of specialized markets. Solvay Pharmaceuticals core activities consist of discovering, developing and manufacturing medicines for human use. Solvay Pharmaceuticals is a member of the worldwide Solvay Group of chemical and pharmaceutical companies, headquartered in Brussels, Belgium.
Solvay Pharmaceuticals has been at the forefront of influenza vaccine research and production for more than 50 years and today plays a critical role in the global advancement of scientific knowledge on influenza and vaccination. Today, Solvay's Influvac® is currently used for the prevention of seasonal influenza in more than 60 countries worldwide and over 200 million doses have been sold to date. Solvay Pharmaceuticals provides 23% of season vaccines in Western Europe.
Solvay Pharmaceuticals works in partnership with governments around the world to produce and supply influenza vaccines for a pandemic influenza outbreak. The company is actively involved in key international industrial organisations and collaborative groups including European Vaccine Manufacturers (EVM), European Scientific Working group on Influenza (ESWI), Influenza Vaccine Supply International Task Force, Joint EMEA Industry Task Force and Asia-Pacific Advisory Committee on Influenza (APACI).
For further information please contact:
Arabella Naylor
Ketchum
Telephone: + 44 (0)207 611 3629
E-mail: arabella.naylor@ketchum.com
Linda Munro
Ketchum
Telephone: + 44 (0)207 611 3691
Email: linda.munro@ketchum.com
1 James Ryan et al, Establishing the health economic impact of influenza vaccination within the European Union 25 countries, Vaccine 2006 Nov;24(47-48):6812-6822
2 WHO Global Pandemic Influenza Action Plan to Increase Vaccine Supply. October 2006.
Journal
Vaccine