title: Influenza vaccination coverage and reasons to refrain among high-risk persons in four European countries.
abstract: This paper examines influenza vaccine coverage using a population base of an average of 2300 persons in each of four European countries (Germany, Spain, Poland and Sweden). The reasons for non-vaccination of those in the high-risk groups were explored by questionnaire. The vaccine coverage rate (VCR) for elderly ranged from 18% in Poland to 67% in Spain. The VCR for high-risk population under 65 was 10% in Poland, 13% in Sweden, 27% in Germany and 30% in Spain. The most important reasons mentioned for not being vaccinated were: perceived sufficient resistance to flu (33-42%) in all countries; financial barriers in Poland (25%), and not to qualify for the vaccination (30%) and forgetfulness (20%) in Germany. Receiving a personal invitation for the vaccination, results in higher coverage rates in all four countries. We think that future interventions could be directed towards: an information campaign with special attention to the high-risk groups due to disease; promotion of personal invitations; and, for Poland, solving financial barriers to vaccination.
authors.affiliation: NIVEL, Netherlands Institute of Health Services Research, P.O. Box 1568, 3500 BN Utrecht, The Netherlands. m.kroneman@nivel.nl
authors.forename: Madelon
authors.initials: M
authors.lastname: Kroneman
authors.forename: Gerrit A
authors.initials: GA
authors.lastname: van Essen
authors.forename: W
authors.initials: W
authors.lastname: John Paget
mesh_terms: D000368:Aged; D001290:Attitude; D002675:Child, Preschool; D003625:Data Collection; D005060:Europe / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007251:Influenza, Human / Q000276:immunology / Q000517:prevention & control*; D010342:Patient Acceptance of Health Care; D011044:Poland / Q000453:epidemiology; D012306:Risk; D013030:Spain / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data*