Flu vaccines: progress towards more effective and appropriate protection

Influenza is an infection that is never trivial, as certain superficial communication sometimes suggests. It is in fact the most widespread infectious disease in the world, whose impact is measured in 1 billion estimated cases each year, of which 3-5 million are severe forms, leading to 300,000-600,000 deaths each year. To stay with the data in our country, influenza has been particularly aggressive and widespread in the last three post-pandemic flu seasons. Last year, over 16 million cases were estimated, and this year, data up to the beginning of March indicate that over 12 million cases have already occurred (and the cold season is not yet over). Deaths directly caused by influenza are at least 8,000-10,000 each winter season, but to these must be added the later deaths related to the decompensation of pre-existing chronic diseases and the higher incidences of heart attacks and strokes in the elderly and frail population affected by the disease.

It is therefore understandable how the possibility of preventing such consequences through an increasingly wide and appropriate use of vaccination is an issue of great relevance for public health.

The progress and challenges posed by the prevention of influenza were recently discussed in Rome at the seventh edition of FluDay, a now traditional meeting between the most important national health institutions (Ministry of Health, Istituto Superiore di Sanità, Regions) and experts and operators in the sector (hygienists, general practitioners, paediatricians and pharmacists).

The meeting first of all provided an opportunity to take stock of vaccination coverage trends in recent seasons. Vaccination coverage in the over-65 population has remained essentially unchanged, despite a framework of increased doses administered. The apparent contradiction stems largely from the increase in the elderly population. In fact, the 'baby-boom' generations of the 1960s, which were particularly numerous, are now entering the over-65 age group, where most of the major damage from influenza is concentrated. Thus, by increasing the denominator, we find ourselves in the paradoxical situation where efforts to reach the population do not translate into increased coverage, but sometimes even into decreased coverage. In this sense, further involvement of pharmacies and GPs (especially in some regions) could make an important contribution to increasing doses administered and vaccination coverage.

On the contrary, in all regions there is a progressive increase in paediatric coverage (the vaccine is offered free of charge between 6 months and 6 years of age), which is important both to protect the youngest from the consequences of the disease (under two years of age, influenza is just as serious as in the elderly), and to interrupt the transmission of the virus, since children are its most important spreaders in the population.