Priority Risk Groups for Influenza Vaccination

Priority risk groups for influenza vaccination 4 SUMMARY At the request of the European Commission, ECDC has conducted a scientific public health review concerning influenza risk groups * and other groups that are offered immunisation against seasonal influenza in Europe. The specific objectives of this study were: • to describe the risk groups recommended for immunisation in the EU/EEA countries, along with details of other groups for which immunisation is offered; • to summarise the supporting evidence for the risk groups that are recommended for vaccination; • to suggest a prioritisation of risk groups in the EU, based on transparent criteria; • to broadly estimate the number of people in EU countries in priority risk groups; and • to identify areas for further work, including research and development. The descriptions of the influenza risk groups and the other groups to whom immunisation is currently offered came from a survey conducted in 2008 by the VENICE project working in conjunction with ECDC. According to the criteria developed by ECDC/VENICE, risk groups should be well-defined groups shown to be more likely to develop severe disease than others. In addition, there should be published evidence that their risk of becoming infected was reduced by immunisation. On the first criterion, the work was hampered by the fact that currently no routine surveillance is conducted in Europe for severe influenza-associated morbidity and mortality. Occupational health criteria (primarily immunising health workers) without demonstrated benefit to patients were noted but given a lower weight — with the exception of one group of workers, those caring for elderly people in residential settings where there is good evidence of this protecting patients. Finally, the degree of consensus among EU countries was noted. The analysis of literature indicates that there are two risk groups where routine annual immunisation with seasonal influenza vaccine is justifiable on scientific and public health grounds in Europe. These are: ● older age groups, usually 65 years and older; and ● people with chronic medical conditions, particularly diseases in the following categories: − chronic respiratory diseases; − chronic cardiovascular diseases; − chronic metabolic disorders; − chronic renal and hepatic diseases; − persons with deficient immunity (congenital or acquired); − young people taking long-term salicylate therapy; and − persons with conditions which compromise respiratory function. These are also the only risk groups for which there is consensus across European Union countries. The exact age definition of the …