Vaccines Europe - 27 Jun 2023
In light of the European Medicines Agency’s (EMA) published recommendations for seasonal flu vaccine composition for the 2023-2024 season on 3 April 2023, members of the Steering Group on Influenza Vaccination are calling on the EU and national authorities to ensure early planning of seasonal influenza, COVID-19 and RSV vaccination programmes for next winter.
The Steering Group has previously called for early demand forecasting for seasonal influenza vaccines, which remains an important public health priority to reiterate for the 2023-2024 season.
- Seasonal flu vaccines are highly technical biological products with complex and lengthy processes for manufacturing, control, and release. This means that orders need to be placed well in advance to ensure adequate supply.
- Ensuring adequate and timely supply enables vaccination programmes to run effectively and on time, allowing healthcare systems to protect populations from seasonal influenza, including the most vulnerable.
Going forward, there are also lessons to be learned from the COVID-19 pandemic for the optimal management of seasonal influenza as well as other viral respiratory diseases such as RSV. There is a need to enhance and further harmonise tools for timely monitoring and surveillance of influenza vaccination coverage rates at the regional level, building on the COVID-19 experience. Tracking vaccination uptake in the eligible population is essential to help support national public health measures and assess progress towards recommended targets.
Furthermore, it is also timely to reflect on the relevance of these points beyond seasonal influenza, as we move out of the pandemic phase of COVID-19. Early demand planning and effective monitoring of vaccine coverage rates are ever more important, considering the concurrent threat of seasonal influenza with new variants of the COVID-19 virus, as seen in the 2022-2023 season. The unpredictability of this new reality, as flagged by WHO Europe in December last year, will require more decisive efforts to protect our populations through stronger vaccination programmes and preparedness measures.
For COVID-19 in particular, this might mean that we need to transition to a more routine approach to vaccination. The EMA has noted that COVID-19 vaccination campaigns may begin to be conducted once a year, similar to seasonal influenza campaigns. Since its emergence, SARS-CoV-2 has evolved rapidly, and it remains to be seen how it will mutate. While vaccines have demonstrated continued protection from severe disease and mortality against variants, protection is diminished against infection and symptomatic illness for some variants, most notably Omicron, which has become the dominant circulating strain. Further, vaccine-induced immunity appears to wane over time, necessitating revaccination.
It will also be important to take key lessons from seasonal influenza to COVID-19. For the samereasons raised above for seasonal influenza, while timelines for flu and COVID-19 strain selection may vary, clear and timely communication on the strain selection process will be critical also for COVID-19, to enable manufacturing and delivery in a timely manner, avoiding shortages.
The annual experience of seasonal influenza vaccines can provide an example of how to manage vaccination against a constantly evolving virus, with a timely recommendation from the EMA. In this regard, we welcome the WHO’s statement on the antigen composition of COVID-19 vaccines, which should continue being communicated in a routine manner in future years.
Another important issue to consider is related to vaccine confidence. As the European Commission’s 2022 report on the State of Vaccine Confidence in the European Union reports, many of the gains in vaccine confidence witnessed in the previous years have faded, particularly with regard to the seasonal influenza vaccine. Large variations in confidence are recorded among EU countries, as well as a worrying trend of a vaccine confidence gap between old and young. Therefore, for both flu and COVID-19, we need annual monitoring of vaccine confidence levels, as detecting changes in the acceptance of vaccines is essential to develop rapid and appropriate responses.
As the Steering Group on Influenza Vaccination, we remain committed to working with the stakeholder community as well as EMA, the European Commission and WHO Europe to prevent the impact of viral respiratory diseases in the 2023-2024 season, including seasonal influenza, COVID-19 and RSV.
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