Influenza-vaccination: an inventory of strategies to reach the target population and optimise vaccination uptake.

Background: Influenza continues to be a considerable health problem of the populations in Europe. Complications of influenza are especially present in elderly patients and patients with chronic conditions such as cardiovascular disorders and respiratory disorders. Vaccination is an effective intervention, however, there is despite the evidence on effectiveness, considerable variation among European countries uptake rates for vaccination. For future pandemic planning at European level, it will be useful to be able to identify the countries ability to reach the patients at risk. Aim: So far, no information is available about how countries inform and recruit the target population for the influenza-vaccination. Also the vaccination distribution methods are unknown. To gain insight, the following research questions have been formulated: 1. Do countries monitor the vaccination rates of the different groups at risk? If yes, how do they monitor and what is the vaccination rate for each group? 2. By which methods are the target population informed and recruited and which distribution channels are used for which target groups? Methods: A questionnaire was sent to key figures in 27 European countries (spring 2002). From the literature, different groups of patients are distinguished that qualify for immunisation based on health status or social position. Based on this information the questionnaire was composed, dealing with practical organization of administration of vaccinations, target group recruitment and vaccination uptake. Results: Only few countries monitor vaccination rates. Those countries that do monitor vaccination rates can provide age specific rates, but hardly any risk group specific rates. The GP is the most important person in administering vaccinations. Some countries provide extra remuneration for GPs for each vaccination provided. Most countries use mass-media to inform the target population. Conclusions: A problem in monitoring vaccination rates is the lack of knowledge of population denominators. When the vaccinations of those at risk are monitored and the number of persons belonging to this group is unknown, no rates can be computed. (aut. ref.