An ecological study on influenza vaccination coverage and mortality in EuropeMore uncertainty than certainty

Background: Influenza viruses have been a threat to global public health for centuries. Millions of individuals are believed to suffer from influenza infection annually, of whom 250 000 to 500 000 die from the disease. Influenza is a vaccine preventable disease. Vaccination is recommended primarily in elderly individuals, despite great uncertainty of the benefits this prevention approach provides. Study aim: The aim of this study is to analyze, if there is an association between influenza vaccination coverage rate (IVC) in the high-risk population ≥ 65 years old and mortality from all causes as well as influenza specific mortality in the elderly aged ≥ 65 years. Methods: The study has an ecologic study design. It is based on annual national data from the European Unions statistical statistic office Eurostat and from the Organization for Economic Co-operation and Development. A descriptive data analysis was performed and correlations between IVC and mortality rates were assessed. Analyses were carried out on national-level and on above national-level