title: Influenza vaccination coverage among high-risk groups in 11 European countries.
abstract: BACKGROUND
  National vaccination coverage rates for individuals at increased risk of influenza-related complications represent a useful public health indicator of preparedness. We compared European countries regarding (i) vaccination coverage among high-risk groups and (ii) the likelihood that high-risk individuals reported influenza vaccination compared with those at lower risk.
  
  
  METHODS
  We used data from the Survey of Health, Ageing and Retirement in Europe (SHARE) collected in 2004-05. Adults aged ≥ 50 years from 11 countries provided self-reports of an influenza vaccination in the previous year (n = 16,913). We defined four high-risk groups (age ≥ 65 years, presence of vascular disease, chronic lung disease or diabetes) and calculated vaccination coverage with 95% confidence intervals for each country. Country-specific multivariable logistic regression was used to estimate odds ratios (ORs) for membership in a high-risk group and vaccination.
  
  
  RESULTS
  The Netherlands had the highest influenza vaccination coverage in high-risk groups (≥ 75% in any group) while Greece had the lowest (<27% in any group). Older age was positively associated with report of vaccination in all countries, but the strength of this association varied from an OR of <2 (Germany) to >13 (The Netherlands). The ORs for the chronic disease groups was ≥ 4 for The Netherlands and were considerably lower (and often not statistically significant) for the other countries.
  
  
  CONCLUSIONS
  Influenza vaccination coverage among high-risk groups varies considerably between European countries. Our findings highlight potential opportunities for reducing influenza-related complications through support for vaccination programs that target high-risk individuals more effectively.
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. adrian.loerbroks@medma.uni-heidelberg.de
authors.forename: Adrian
authors.initials: A
authors.lastname: Loerbroks
authors.forename: Christian
authors.initials: C
authors.lastname: Stock
authors.forename: Jos A
authors.initials: JA
authors.lastname: Bosch
authors.forename: David G
authors.initials: DG
authors.lastname: Litaker
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Apfelbacher
mesh_terms: D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D005060:Europe / Q000453:epidemiology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D007407:Interviews as Topic; D016013:Likelihood Functions; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines