Boosting Influenza Vaccination Coverage Requires Improved Access, Trust: Marco del Riccio, MD

Amid the many barriers to optimal influenza vaccination coverage, Marco del Riccio, MD, of the University of Florence in Italy, emphasizes the importance of prioritizing patients at the highest risk, particularly older adults and those with comorbidities.

Watch parts 1, 2, and 3 to learn about the inspiration behind the Flunomics report, published by Sanofi in collaboration with del Riccio; the disproportionate impact of influenza on older US populations; and how health systems can better plan for future influenza seasons.

This transcript has been lightly edited; captions were auto-generated.

Transcript

Overall influenza vaccine coverage in the US was just 34%. Why does uptake continue to lag, particularly among high-risk adults?

We know that this is very, on one hand, country-specific, population-specific, and vaccine-specific. In every country where we study vaccine coverage, acceptance, and efficacy, it depends on many factors, factors that are population factors but also on the type of training received by the health care providers. Are the health care providers recommending influenza vaccines every season? Are they trained to recommend it? Are there leverages for them? For instance, are they paid a specific amount of money depending on how many vaccines they administer every winter? Sometimes they do, and this is leverage to recommend.

The barrier to accessing the vaccination is another key factor. For instance, in Europe, but also in the US, geographically, it's not always as easy as in other parts of the country to have access to a vaccination. In terms of what we have to do to make that coverage higher, we certainly need to make access to the vaccination easier, both in terms of logistics and price, of course, if somebody has to pay.

Key recommendations are important. So, is it recommended? Is it free? If it's not free, how much does it cost? If it's recommended, for which group? Am I in the target group for the vaccination? These are, let's say, within the group of things that are important for those who are not anti-vax or hesitant. Then, it comes to the single, specific type of vaccine.

There are some misconceptions about understanding, at least sometimes, influenza coverage. There are some people who think that with the influenza vaccine, you can develop the flu, which is 100% not correct because no flu vaccine is a live attenuated vaccine. We do not have live attenuated vaccines for the flu, so it's basically actually impossible to catch the flu, but sometimes you have some misconceptions.

Not to touch the current political environment, which is, generally speaking, not 100% supportive of vaccinations in general, in the world, and also in the US. These are things that can influence coverage. We have seen from many studies, not only in the US, but also in the US, that trust in institutions is something that really has an impact on trusting recommendations and therefore vaccines in general, not only the flu. These are all things to be considered when interpreting vaccine coverage.

One important thing is that I would put efforts into the risk groups, based on age or based on comorbidities and risks. I wouldn't be as worried for the general population. The 33% coverage is 1 in 3 [patients]. We know it's not optimal, but it’s still better than many other countries.

But we do have some groups that would have the most benefit from the vaccination, which are the older adults, immunocompromised people, people with comorbidities, people with many comorbidities, cardiovascular patients, diabetic patients, etc. In these specific groups, we're still with suboptimal coverage. If the recommendation predominantly shows it's 3 out of 4 [patients], we're not reaching that target, so I think it's important to ask about it.