Long-Term Correlation between Influenza Vaccination Coverage and Incidence of Influenza-Like Illness in 14 European Countries.
We aimed to examine the long-term correlation between influenza vaccination coverage and the incidence of influenza-like illness (ILI) in the total and elderly populations of European countries for which data was available on at least six consecutive influenza seasons. We graphically visualised vaccination coverage and ILI incidence trends and calculated Spearman rank correlation coefficients. Additionally, we fitted a negative binomial regression model to estimate the change in ILI incidence per percentage point change in vaccination coverage. We found significant negative correlations for the total population of the Netherlands (ρ = -0.60, p-value = 0.003) and for the elderly populations of England (ρ = -0.80, p-value < 0.001) and Germany (ρ = -0.57, p-value = 0.04). However, results were not consistent, and for some countries we observed significant positive correlations. Only for the elderly in England was there a significant decline in incidence rate per percentage point increase in vaccination coverage (incidence rate ratio = 0.93; 95% confidence interval 0.88-0.99). Based on this ecological study it is not possible to provide evidence for a negative correlation between influenza vaccination coverage and ILI incidence. For future, aetiological studies to assess impact of influenza vaccinations on the population, there is a need for high quality data over long periods of time, on proportion of ILI caused by influenza virus infection, on severe outcome measures such as hospitalisation for influenza, and on other factors that potentially affect influenza transmission.
Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Ineke T
IT
Spruijt
Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Marit M A
MM
de Lange
Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Frederika
F
Dijkstra
NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
Gé A
GA
Donker
Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Wim
W
van der Hoek
Euro Surveill. 2008 Oct 09;13(41):null
18926107
Vaccine. 2014 Apr 17;32(19):2143-9
24582634
BMC Infect Dis. 2007 Nov 30;7:141
18047685
Euro Surveill. 2007 May 17;12(5):E070517.2
17868597
Stat Med. 2013 Jun 30;32(14):2390-405
23239019
BMC Public Health. 2013 Dec 05;13:1130
24314008
Vaccine. 2014 Jan 9;32(3):350-4
24269621
BMC Public Health. 2008 Aug 01;8:272
18673545
Int J Infect Dis. 2013 Dec;17(12):e1194-7
24084246
BMC Infect Dis. 2015 Mar 20;15:137
25887460
PLoS One. 2013 Oct 16;8(10):e76318
24146855
PLoS One. 2011;6(11):e27622
22110695
Hum Vaccin Immunother. 2012 Jan;8(1):89-95
22251992
Vaccine. 2006 Oct 30;24(42-43):6468-75
16876293
Hum Vaccin Immunother. 2014;10(2):449-55
24280728
Epidemiol Infect. 2009 Apr;137(4):473-9
18789176
Euro Surveill. 2013 Nov 07;18(45):20628
24229790
Vaccine. 2011 Jun 15;29(27):4492-8
21545822
PLoS One. 2013 Jun 19;8(6):e66312
23840439
J Public Health (Oxf). 2005 Dec;27(4):371-7
16207735
Euro Surveill. 2006;11(10):249-50
17130657
BMC Infect Dis. 2007 Dec 10;7:144
18070354
Vaccine. 2015 Feb 25;33(9):1099-101
25604800
Vaccine. 2010 Feb 3;28(5):1156-67
20004635
BMC Public Health. 2014 Aug 07;14:813
25103091
Euro Surveill. 2014 Apr 24;19(16):20780
24786262
Vaccine. 2010 Sep 7;28 Suppl 4:D3-13
20713258
Health Policy. 2000 May;52(1):1-13
10899641
Vaccine. 2005 Apr 22;23(22):2844-50
15841577
Pharmacotherapy. 2010 Dec;30(12 ):1199-206
21114386
Euro Surveill. 2014 Feb 13;19(6):null
24556348
J Virol. 2014 Jul;88(14):7692-5
24789791
Infection. 2009 Oct;37(5):390-400
19768382
Euro Surveill. 2013 Jan 31;18(5):null
23399425
Influenza Other Respir Viruses. 2008 Jul;2(4):139-45
19453466
BMC Public Health. 2012 Oct 31;12:938
23113995