OBJECTIVES: Influenza is a highly infectious viral disease that imposes a significant healthcare burden with 49 million cases in US and 17.8 million in Europe in 2018. Moreover, there is a difference in influenza vaccination rate in the US (69.1%) and Europe (47.1%). Therefore, we assessed disparities and similarities in recommendations for influenza vaccination across US and EU-5.

METHODS: National guidelines providing recommendations on influenza vaccine were searched for US (ACIP), UK (PHE), France (HCSP), Italy, Spain (PHC) and Germany (MoH) published in 2018-19.

RESULTS: Influenza vaccine recommendations have been provided for different age-groups, pregnant-women, healthcare workers, healthy household contacts of high-risk groups and caregivers. Significant disparity was observed in influenza vaccine recommendations in US and EU-5 across age-groups, healthy household contacts of high-risk groups, and caregivers. First, ACIP has recommended a routine annual vaccination for children aged ≥6 months in US who do not have contraindications. European authorities, to the contrary, have recommended annual vaccination to all persons aged ≥60 years. Second, vaccination is recommended to healthy household contacts of high risk groups in US, France, Italy and Spain, but not in Germany and UK. Third, vaccination is recommended to primary carer of an elderly or disabled person who is not at risk group in US and UK but not in rest of EU-5 countries. Similarity in influenza-vaccination recommendations to all persons suffering from chronic medical conditions aged ≥6 months were observed in both US and EU-5. Likewise, influenza-vaccination is recommended to pregnant women and healthcare workers in both US and EU-5.

CONCLUSIONS: Potential reason of identified disparity across US and Europe can be attributed to difference in influenza incidence in both children and elderly population that leads to increased hospitalization and mortality. Thus, there is a need to cover wider-population by European authorities to reduce substantial disease burden on healthcare and society.