Vaccines Europe - 21 Oct 2020
Seasonal influenza poses a significant but often under-recognised challenge to EU health systems. Compared to other infectious diseases, it has one of the highest impacts in terms of mortality and incidence and is estimated to cause up to 70,000 deaths in the EU each year, particularly among older adults and other at-risk groups. This year, the influenza season coincides with the COVID-19 pandemic and hence, it is important to prevent influenza more than ever.
To optimally protect EU public health and health care systems in this unique “twindemic” 2020-2021 influenza season, vaccination should be first offered to the highest priority groups (healthcare workers, older adults) as well as additional risk groups (pregnant women, individuals with underlying health conditions, children) in countries where vaccine supplies are limited. Where product supply is limited, full-service healthcare distributors can support the rational allocation of vaccines towards vaccination sites, such pharmacies, which are instrumental in carrying out broad ranging immunisation programmes for the population. Furthermore, early information to downstream supply chain stakeholders about demand, released batches and market conditions are key to success flu vaccination programmes.
To support the delivery of the 2020-2021 vaccination campaign in a COVID-19 setting, lessons can be learned from the Southern Hemisphere 2020 campaign where (i) strong political leadership, along with clear and consistent messaging across all stakeholders, supported maintaining vaccine uptake (ii) vaccination points were expanded to e.g. pharmacies, nursing homes, drive-throughs, church halls, schools, exterior to GP surgeries and (iii) vaccination campaigns were extended through the season to address social-distancing limitations.
Given the long lead times needed for flu vaccines to be produced, manufacturers have made all possible efforts to increase the production levels in these exceptional COVID-19 pandemic circumstances. However, the capacity to produce more seasonal influenza vaccines in the short campaign window available is limited and it was not possible for all the late extra demand to be addressed. Even in such circumstances, the Vaccines Europe company members achieved to increase their influenza vaccine supply in Europe by an average of 30% for 2020/2021 influenza season. At the same time, healthcare distributors have intensified efforts to respond to this unusual increase in demand by allocating the vaccine doses fairly and efficiently to where they are needed most.
One of the main lessons that has been learned from this situation is the importance of better forecasting and advanced planning. However, sustaining higher levels of uptake from season to season is also needed to ensure supply continuity during future public health emergencies as well as expand capacity for pandemic influenza vaccines, speeding response.
As preparation for influenza vaccine production commences one year in advance of delivery with sourcing of raw materials, understanding demand at the outset of this manufacturing planning period is critical to increasing supply for the next influenza season.
Policy changes which help to drive an increase in flu vaccinations are welcomed and should be sustained in the future in the interest of public health to (i) meet the 75% influenza vaccination target rate in at-risk groups; and (ii) to prepare for future pandemics. In order to achieve this for future seasons, the focus should be on moving procurement dialogues and decisions earlier to allow to better anticipate policy changes and the evolution of vaccination recommendations. This will enable more accurate forecasting of demand, particularly if significant vaccine volumes will be required.
 WHO SAGE Seasonal Influenza Vaccination Recommendations during Covid-19 Pandemic, 21 September 2020: https://www.who.int/immunization/policy/position_papers/Interim_SAGE_influenza_vaccination_recommendations.pdf?ua=1.
 Data provided by Vaccines Europe Members (Abbott, GSK, Sanofi Pasteur, Seqirus) in October 2020.