As Northern Hemisphere countries enter another influenza season, seasonal influenza continues to place predictable pressure on health systems, particularly for children, older adults and people living with chronic conditions. As populations age and non communicable diseases rise, the consequences of influenza become more severe, more costly, and more difficult for systems to absorb. 

The burden of influenza

The burden of this acute respiratory infection caused by influenza viruses is significant and multifaceted, in terms of number of respiratory deaths, serious and life changing health complications notably for people suffering from non-communicable diseases (NCD), as well as in terms of economic costs including outpatient care and productivity losses across the workforce due to hospitalizations. Seasonal influenza epidemics result in 3-5 million cases of severe illness and up to 650,000 respiratory deaths worldwide each year.  

The benefit of a higher influenza immunization coverage 

Vaccines remain the best way to protect the population and the most vulnerable people against the seasonal influenza. Yet, immunization coverage remains largely under the World Health Organization (WHO) target of 75 % for older adults with only 18% of countries achieving 70% vaccination coverage for older adults. Increasing vaccine coverage constitutes a crucial lever to protect better patients and society, strengthen health security and support competitiveness.  

First, expanding vaccination coverage enables stabilization of health system capacity, safeguards continuity of care, and supports healthy ageing by reducing severe and often life-changing outcomes, across the entire life. Estimates show every 1% increase in global influenza vaccination coverage would result in over 18,000 avoided hospitalizations every year, with direct medical cost savings across all settings. As examples, studies highlight that influenza vaccination can reduce the risk of death from stroke by 50%, protecting better patients with cardiovascular conditions, and it is associated with a 66% lower likelihood of flu-related medical care among people living with diabetes. 

Then, influenza vaccination coverage is critical to drive antimicrobial stewardship notably by reducing influenza-related complications that drive antibiotic use.  

Greater influenza vaccination coverage supports healthy ageing by reducing severe and potentially life-changing outcomes across the life course, from children and working-age adults to older people; and protects vulnerable populations, including those living with chronic cardiovascular, respiratory or metabolic conditions.  

It also preserves workforce productivity by preventing illness-related absenteeism. A 2022 study shows that influenza and influenza-like illness result in 0.5 to 5.3 days of work absence per episode among healthy adults,  while the average ranges from 0.5 to 3.2 workdays among healthcare workers. For employers, influenza vaccination can reduce absenteeism and workplace disruption during seasonal outbreaks. By helping employees remain healthy and productive, vaccination supports business continuity and reduces the operational impacts of seasonal influenza. 

Even modest investments in coverage can generate significant returns for individuals, health systems and society. According to a recent analysis, across high- and middle-income settings, influenza vaccination can generate up to USD 22 in societal benefits for every USD 1 invested.

Every 1% increase in influenza vaccination coverage delivers measurable health and economic benefits

Unlocking the full value of influenza immunization  

Reducing the burden of influenza is a collective endeavor across governments, healthcare providers, and industry. Six actions can unlock the full value of influenza immunization: 

• Strengthen national leadership and coordination. Set clear priorities, plans and responsibilities for delivery. 
• Make influenza vaccination part of routine care. Embed it in chronic disease management and healthy ageing strategies.
• Empower healthcare providers to vaccinate. Give them the authority, incentives and support to achieve high coverage.
• Build public confidence and demand. Use clear, consistent and evidence-based communication to demonstrate value and counter misinformation.
• Make influenza vaccination central to preparedness. Use it to strengthen health system resilience and advance health security. 
• Make vaccination easier to access. Offer convenient vaccination through multiple trusted touchpoints, including pharmacies and at the workplace. 

The importance of making influenza vaccination accessible is something I have experienced first-hand throughout my career. I started my career as a community pharmacist in Portugal, administering influenza vaccines every year and I could see first-hand the value of seasonal influenza vaccination. It is a subject quite dear to me and, even if I no longer work as a pharmacist, I make sure that my IFPMA colleagues have the opportunity to get the flu shot every year, helping protect themselves as employees but also friends, family, and the communities around them.  

Author

• 
  Paula Barbosa Deputy Director, Vaccines Policy p.barbosa@ifpma.org