In Ireland the Health Protection Surveillance Centre (HPSC) collates influenza vaccine uptake statistics in those aged 65 years and older based on data obtained from the Primary Care Reimbursement Service (PCRS), HSE- Finance Shared Services. These data provide information on the number of patients vaccinated with influenza vaccine (by age group and HSE-Area of residence), attendance at GP clinics and pharmacies for vaccination and the number of registered medical and GP visit cardholders aged 65 years and older. The number of patients vaccinated with influenza vaccine refers to GP and pharmacy paid claims for influenza vaccination reported by the PCRS and so are dependent on GPs’ and pharmacist’s claims for reimbursement. Data from pharmacies are only available for the 2012/2013 influenza season when administration of influenza vaccine by pharmacists commenced.
As highlighted, the uptake of influenza vaccine in those aged 65 years and older decreased from 70% in the 2008/2009 to 56.9% in 2011/2012. These estimates are based on PCRS data received by HPSC. The uptake in the season 2008/2009 was the highest uptake reported. The reason for this decline is unknown but as previously stated may be due to data received by PCRS which is dependent on GPs’ and pharmacist’s claims for reimbursement. Data from pharmacies were only available for the 2012/2013 influenza season when administration of influenza vaccine by pharmacists commenced which may have influenced 2011/2012 season data. In addition, during the period 2011/2012 data reported were not complete as PCRS did not report vaccinations administered by GPs and claimed through the new vaccination claiming system. The 2012/2013 dataset is not fully complete from PCRS and it may improve when the complete dataset is received. In 2008/2009 there were a number of high profile avian influenza H5N1 outbreaks in UK and other European countries. It is also possible that the higher uptake noted that year reflected a mistaken belief that seasonal influenza vaccine would protect against H5N1 avian influenza.
Of note is that a national telephone survey undertaken after the 2012/2013 influenza season measuring influenza vaccine uptake reports 59.9% coverage (provisional data) in those aged 65 years and over which is similar to the uptake recorded in the previous season i.e. 2011/2012 season. This survey also explored the reasons for non-vaccination among respondents.
Respondents in the age group 65 years and over perceived themselves as not needing the influenza vaccine and of not being at risk of contracting influenza. In those who were vaccinated, recommendation by the GP was a strong predictor of influenza vaccination.
As pointed out the influenza vaccine coverage in this age group is below the WHO target of 75% and this is of concern. Efforts to improve flu vaccine uptake in those aged 65 years and older are made annually by launching the influenza vaccination campaign (media and written materials by the National Immunisation Office) at the start of the influenza season. In addition, HSE areas communicate to all nursing homes and residential care units at the start of each flu season regarding the importance of improving influenza vaccine uptake among elderly residents.
Table 1: Cumulative percentage seasonal influenza vaccine uptake in Medical Card Holders aged 65 years and older by season (September – August), attending GP clinics.
Sept - August
|
2011/12
|
2010/11
|
2009/10
|
2008/09
|
2007/08
|
2006/07
|
2005/06
|
2004/05
|
Mean
|
No. vaccinated
|
250,525
|
276,240
|
225,358
|
294,156
|
259,100
|
246,695
|
249,013
|
236,425
|
254,689.0
|
No. Medical card holders *
|
444,628
|
432,650
|
419,010
|
419,327
|
419,767
|
407,196
|
395,458
|
385,162
|
415,400
|
% Uptake
|
56.3
|
63.8
|
53.8
|
70.1
|
61.7
|
60.6
|
63.0
|
61.4
|
61.3
|
The number of Medical card holders includes GP visit card holders and represents the average number of card holders for the period September 2011 - August 2012.