Decline in influenza-associated mortality among Dutch elderly following the introduction of a nationwide vaccination program

Vaccine. 2008 Oct 16;26(44):5567-74. doi: 10.1016/j.vaccine.2008.08.003. Epub 2008 Aug 21.


With a retrospective nationwide cohort study in the Netherlands over 1992-2003, using mortality and viral surveillance data, the aim was to assess by means of rate difference methods the influenza-associated mortality in the elderly before and after the introduction of a nationwide influenza vaccination program in 1996 (vaccination coverage raised from below 50 to 80%). The average annual influenza-associated mortality declined in the years before and after the introduction from 131 to 105 per 100,000 persons (relative risk 0.80). The decline was largest in the age group 65-69 years (relative risk 0.54) and less in those aged 75 years and older. Validation by Serfling-type regression analysis revealed similar results. In conclusion, routine influenza vaccination among Dutch elderly was associated with a significant decrease in influenza-associated mortality, notably in those aged 65-69 years.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Humans
  • Immunization Programs*
  • Influenza A Virus, H3N2 Subtype
  • Influenza Vaccines / administration & dosage*
  • Influenza, Human / epidemiology
  • Influenza, Human / mortality*
  • Influenza, Human / prevention & control*
  • Influenza, Human / virology
  • National Health Programs*
  • Netherlands / epidemiology
  • Population Surveillance / methods
  • Program Evaluation
  • Seasons


  • Influenza Vaccines