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Impact of influenza vaccination programmes among the elderly population on primary care, Portugal, Spain and the Netherlands: 2015/16 to 2017/18 influenza seasons
- Ausenda Machado1,2,3 , Clara Mazagatos2,4 , Frederika Dijkstra2,5 , Irina Kislaya1,3 , Alin Gherasim4 , Scott A McDonald5 , Esther Kissling6 , Marta Valenciano6 , Adam Meijer5 , Mariëtte Hooiveld7 , Baltazar Nunes1,3 , Amparo Larrauri4
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View Affiliations Hide AffiliationsAffiliations: 1 National Institute for Health Doutor Ricardo Jorge, Epidemiology department, Lisbon, Portugal 2 These authors contributed equally 3 NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal 4 National Centre of Epidemiology, Carlos III Health Institute, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain 5 National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands 6 Epidemiology department, Epiconcept, Paris, France 7 Nivel, Netherlands Institute for Health Services Research, Utrecht, the NetherlandsAusenda Machadoausenda.machado insa.min-saude.pt
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Citation style for this article: Machado Ausenda, Mazagatos Clara, Dijkstra Frederika, Kislaya Irina, Gherasim Alin, McDonald Scott A, Kissling Esther, Valenciano Marta, Meijer Adam, Hooiveld Mariëtte, Nunes Baltazar, Larrauri Amparo. Impact of influenza vaccination programmes among the elderly population on primary care, Portugal, Spain and the Netherlands: 2015/16 to 2017/18 influenza seasons. Euro Surveill. 2019;24(45):pii=1900268. https://doi.org/10.2807/1560-7917.ES.2019.24.45.1900268 Received: 30 Apr 2019; Accepted: 23 Sept 2019
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Abstract
To increase the acceptability of influenza vaccine, it is important to quantify the overall benefits of the vaccination programme.
To assess the impact of influenza vaccination in Portugal, Spain and the Netherlands, we estimated the number of medically attended influenza-confirmed cases (MAICC) in primary care averted in the seasons 2015/16 to 2017/18 among those ≥ 65 years.
We used an ecological approach to estimate vaccination impact. We compared the number of observed MAICC (n) to the estimated number that would have occurred without the vaccination programme (N). To estimate N, we used: (i) MAICC estimated from influenza surveillance systems, (ii) vaccine coverage, (iii) pooled (sub)type-specific influenza vaccine effectiveness estimates for seasons 2015/16 to 2017/18, weighted by the proportion of virus circulation in each season and country. We estimated the number of MAICC averted (NAE) and the prevented fraction (PF) by the vaccination programme.
The annual average of NAE in the population ≥ 65 years was 33, 58 and 204 MAICC per 100,000 in Portugal, Spain and the Netherlands, respectively. On average, influenza vaccination prevented 10.7%, 10.9% and 14.2% of potential influenza MAICC each season in these countries. The lowest PF was in 2016/17 (4.9–6.1%) with an NAE ranging from 24 to 69 per 100,000.
Our results suggest that influenza vaccination programmes reduced a substantial number of MAICC. Together with studies on hospitalisations and deaths averted by influenza vaccination programmes, this will contribute to the evaluation of the impact of vaccination strategies and strengthen public health communication.

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