Vaccine 32 (2014) 6369–6376
Contents lists available at ScienceDirect
Vaccine journal homepage: www.elsevier.com/locate/vaccine
Review
Seasonal influenza vaccine dose distribution in 157 countries (2004–2011) Abraham Palache a,∗ , Valerie Oriol-Mathieu b , Atika Abelin c , Tamara Music d , on behalf of the Influenza Vaccine Supply task force (IFPMA IVS) a
Abbott, C.J. van Houtenlaan 36, 1381 CP, Weesp, The Netherlands Crucell Holland B.V., Newtonweg 1, 2333 CP, P.O. Box 2048, 2301 Leiden, CA, The Netherlands c Sanofi Pasteur, 2, Avenue Pont Pasteur, Lyon 69007, France d International Federation of Pharmaceutical Manufacturers and Associations, Ch. Louis-Dunant 15, P.O. Box 195, 20 1211 Geneva, Switzerland b
a r t i c l e
i n f o
Article history: Received 5 February 2014 Received in revised form 12 June 2014 Accepted 8 July 2014 Keywords: Seasonal influenza Vaccination policy Vaccine recommendations Vaccine reimbursement Vaccination coverage rates Monitoring and evaluation
a b s t r a c t Globally there are an estimated 3–5 million cases of severe influenza illness every year, resulting in 250,000–500,000 deaths. At the World Health Assembly in 2003, World Health Organization (WHO) resolved to increase influenza vaccine coverage rates (VCR) for high-risk groups, particularly focusing on at least 75% of the elderly by 2010. But systematic worldwide data have not been available to assist public health authorities to monitor vaccine uptake and review progress toward vaccination coverage targets. In 2008, the International Federation of Pharmaceutical Manufacturers and Associations Influenza Vaccine Supply task force (IFPMA IVS) developed a survey methodology to assess global influenza vaccine dose distribution. The current survey results represent 2011 data and demonstrate the evolution of the absolute number distributed between 2004 and 2011 inclusive, and the evolution in the per capita doses distributed in 2008–2011. Global distribution of IFPMA IVS member doses increased approximately 86.9% between 2004 and 2011, but only approximately 12.1% between 2008 and 2011. The WHO’s regions in Eastern Mediterranean (EMRO), Southeast Asian (SEARO) and Africa (AFRO) together account for about 47% of the global population, but only 3.7% of all IFPMA IVS doses distributed. While distributed doses have globally increased, they have decreased in EURO and EMRO since 2009. Dose distribution can provide a reasonable proxy of vaccine utilization. Based on the dose distribution, we conclude that seasonal influenza VCR in many countries remains well below the WHA’s VCR targets and below the recommendations of the Council of the European Union in EURO. Inter- and intra-regional disparities in dose distribution trends call into question the impact of current vaccine recommendations at achieving coverage targets. Additional policy measures, particularly those that influence patients adherence to vaccination programs, such as reimbursement, healthcare provider knowledge, attitudes, practices, and communications, are required for VCR targets to be met and benefit public health. © 2014 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
1. Introduction Influenza is an important cause of morbidity and mortality globally, resulting in an estimated 3–5 million cases of severe influenza illness and 250,000–500,000 annual deaths worldwide [1]. The annual attack rate with influenza viruses is 5–10% in adults and 20–30% in children [2]. Groups at particular risk of severe
∗ Corresponding author. Tel.: +31 6 512 90531. E-mail addresses: [email protected], bram.palache@flupal.nl (A. Palache), [email protected] (V. Oriol-Mathieu), Atika.Abelin@sanofipasteur.com (A. Abelin), [email protected] (T. Music).
influenza infections include pregnant women, children aged
Contents lists available at ScienceDirect
Vaccine journal homepage: www.elsevier.com/locate/vaccine
Review
Seasonal influenza vaccine dose distribution in 157 countries (2004–2011) Abraham Palache a,∗ , Valerie Oriol-Mathieu b , Atika Abelin c , Tamara Music d , on behalf of the Influenza Vaccine Supply task force (IFPMA IVS) a
Abbott, C.J. van Houtenlaan 36, 1381 CP, Weesp, The Netherlands Crucell Holland B.V., Newtonweg 1, 2333 CP, P.O. Box 2048, 2301 Leiden, CA, The Netherlands c Sanofi Pasteur, 2, Avenue Pont Pasteur, Lyon 69007, France d International Federation of Pharmaceutical Manufacturers and Associations, Ch. Louis-Dunant 15, P.O. Box 195, 20 1211 Geneva, Switzerland b
a r t i c l e
i n f o
Article history: Received 5 February 2014 Received in revised form 12 June 2014 Accepted 8 July 2014 Keywords: Seasonal influenza Vaccination policy Vaccine recommendations Vaccine reimbursement Vaccination coverage rates Monitoring and evaluation
a b s t r a c t Globally there are an estimated 3–5 million cases of severe influenza illness every year, resulting in 250,000–500,000 deaths. At the World Health Assembly in 2003, World Health Organization (WHO) resolved to increase influenza vaccine coverage rates (VCR) for high-risk groups, particularly focusing on at least 75% of the elderly by 2010. But systematic worldwide data have not been available to assist public health authorities to monitor vaccine uptake and review progress toward vaccination coverage targets. In 2008, the International Federation of Pharmaceutical Manufacturers and Associations Influenza Vaccine Supply task force (IFPMA IVS) developed a survey methodology to assess global influenza vaccine dose distribution. The current survey results represent 2011 data and demonstrate the evolution of the absolute number distributed between 2004 and 2011 inclusive, and the evolution in the per capita doses distributed in 2008–2011. Global distribution of IFPMA IVS member doses increased approximately 86.9% between 2004 and 2011, but only approximately 12.1% between 2008 and 2011. The WHO’s regions in Eastern Mediterranean (EMRO), Southeast Asian (SEARO) and Africa (AFRO) together account for about 47% of the global population, but only 3.7% of all IFPMA IVS doses distributed. While distributed doses have globally increased, they have decreased in EURO and EMRO since 2009. Dose distribution can provide a reasonable proxy of vaccine utilization. Based on the dose distribution, we conclude that seasonal influenza VCR in many countries remains well below the WHA’s VCR targets and below the recommendations of the Council of the European Union in EURO. Inter- and intra-regional disparities in dose distribution trends call into question the impact of current vaccine recommendations at achieving coverage targets. Additional policy measures, particularly those that influence patients adherence to vaccination programs, such as reimbursement, healthcare provider knowledge, attitudes, practices, and communications, are required for VCR targets to be met and benefit public health. © 2014 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
1. Introduction Influenza is an important cause of morbidity and mortality globally, resulting in an estimated 3–5 million cases of severe influenza illness and 250,000–500,000 annual deaths worldwide [1]. The annual attack rate with influenza viruses is 5–10% in adults and 20–30% in children [2]. Groups at particular risk of severe
∗ Corresponding author. Tel.: +31 6 512 90531. E-mail addresses: [email protected], bram.palache@flupal.nl (A. Palache), [email protected] (V. Oriol-Mathieu), Atika.Abelin@sanofipasteur.com (A. Abelin), [email protected] (T. Music).
influenza infections include pregnant women, children aged
