INFLUENZA VACCINATION IN 18 DEVELOPED-COUNTRIES, 1980-1992

Influenza continues to be an important cause of preventable morbidity and mortality. Although influenza vaccine is widely recommended for ol der high-risk individuals, no studies have compared its use in differe nt countries. We gathered information on influenza vaccine distributio n in 18 developed countries for the period 1980-1992. During the 1980s there was a greater than or equal to 10-fold difference in annual per capita vaccine distribution among these countries, and in 1992 the di fference was still more than 7-fold. Several countries demonstrated la rge increases in vaccine use over the study period some showing substa ntial increases in specific years. Thirteen of the 18 countries recomm end influenza vaccination for all elderly persons and 11 countries pro vide reimbursement for vaccination through national or social health i nsurance. These countries tend to have higher levels of vaccine use. H istorical, economic and political factors also affect vaccination prac tices and policies, but their relationships to differences in vaccine use between countries are not known. A better understanding of why the use of influenza vaccine varies among countries will be important if its protective benefits are to be fully realized.