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. 2024 May 3;24(1):1222.
doi: 10.1186/s12889-024-18694-5.

Public health and economic benefits of seasonal influenza vaccination in risk groups in France, Italy, Spain and the UK: state of play and perspectives

Thierry Rigoine de Fougerolles  1 , Théophile Baïssas  2 , Guillaume Perquier  1 , Olivier Vitoux  1 , Pascal Crépey  3 , José Bartelt-Hofer  4 , Hélène Bricout  5 , Audrey Petitjean  5
Affiliations

Public health and economic benefits of seasonal influenza vaccination in risk groups in France, Italy, Spain and the UK: state of play and perspectives

Thierry Rigoine de Fougerolles et al. BMC Public Health. .

Abstract

Background: Seasonal influenza epidemics have a substantial public health and economic burden, which can be alleviated through vaccination. The World Health Organization (WHO) recommends a 75% vaccination coverage rate (VCR) in: older adults (aged ≥ 65 years), individuals with chronic conditions, pregnant women, children aged 6-24 months and healthcare workers. However, no European country achieves this target in all risk groups. In this study, potential public health and economic benefits achieved by reaching 75% influenza VCR was estimated in risk groups across four European countries: France, Italy, Spain, and the UK.

Methods: A static epidemiological model was used to estimate the averted public health and economic burden of increasing the 2021/2022 season VCR to 75%, using the efficacy data of standard-dose quadrivalent influenza vaccine. For each country and risk group, the most recent data on population size, VCR, pre-pandemic influenza epidemiology, direct medical costs and absenteeism were identified through a systematic literature review, supplemented by manual searching. Outcomes were: averted influenza cases, general practitioner (GP) visits, hospitalisations, case fatalities, number of days of work lost, direct medical costs and absenteeism-related costs.

Results: As of the 2021/2022 season, the UK achieved the highest weighted VCR across risk groups (65%), followed by Spain (47%), France (44%) and Italy (44%). Based on modelling, the 2021/2022 VCR prevented an estimated 1.9 million influenza cases, avoiding 375,200 GP visits, 73,200 hospitalisations and 38,400 deaths. To achieve the WHO 75% VCR target, an additional 24 million at-risk individuals would need to be vaccinated, most of which being older adults and patients with chronic conditions. It was estimated that this could avoid a further 918,200 influenza cases, 332,000 GP visits, 16,300 hospitalisations and 6,300 deaths across the four countries, with older adults accounting for 52% of hospitalisations and 80% of deaths. An additional €84 million in direct medical costs and €79 million in absenteeism costs would be saved in total, with most economic benefits delivered in France.

Conclusions: Older adults represent most vaccine-preventable influenza cases and deaths, followed by individuals with chronic conditions. Health authorities should prioritise vaccinating these populations for maximum public health and economic benefits.

Keywords: Economic impact; Epidemiology; Influenza; Influenza burden; Modelling; Public health policy; Vaccination coverage rate; Vaccines and immunisation.

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Conflict of interest statement

AP, HB and JBH are employees of Sanofi and may hold shares or stock options in the company.

TB, GP, TRdF and OV are employees of Corporate Value Associates (CVA). TB, GP, TRdF and OV report consultancy fees paid to CVA by Sanofi, during the conduct of the study; and for the submitted work.

PC reports consultancy fees from Sanofi.

Figures

Fig. 1
Fig. 1
Decision flow of the epidemiological model
Fig. 2
Fig. 2
Summary of methodology. EU European; GP general practitioner; SLR systematic literature review; UK United Kingdom; VCR vaccine coverage rate
Fig. 3
Fig. 3
Vaccination gap to reach WHO-recommended 75% VCR target among all the eligible population for influenza vaccination. UK United Kingdom; VCR Vaccination coverage rate; WHO World Health Organization
Fig. 4
Fig. 4
DSA of the average incremental costs or cost savings of increasing the VCR to 75%. DSA Deterministic sensitivity analysis; GP General practitioner; HCW Healthcare worker; VCR Vaccination coverage rate
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