European decision-maker perspective with regard to influenza prevention policies


influenza vaccination
influenza prevention
pandemic preparedness


Influenza is a public health priority in Europe. The impact of influenza pandemics on public health is very high, but also seasonal influenza represents an important burden in terms of hospitalisation and excess deaths. Influenza vaccination is a fundamental pillar of disease prevention. In the absence of a clear decision making process for vaccination policies, during the latest years the EU institutions have fostered some collaboration between Member States. Such collaboration has been more relevant during the 2009 pandemic, in the presence of a clear cross-border threat to EU citizens’ health. The EU institutions have been supporting the national vaccination programmes providing evidence of influenza vaccination effectiveness and safety. Decision 1082/2013 represents a major step toward EU collaboration highlighting the role of pandemic vaccination in the area of emergency preparedness and response, where a clear EU added value is evident.


European Centre for Disease Prevention and Control. Influenza factsheet for health professionals. Available at:

Amato-Gauci A, Zucs P, Snacken R, Ciancio B, Lopez V, Broberg E, et al. Surveillance trends of the 2009 influenza A(H1N1) pandemic in Europe.. Euro Surveill 2011 Jun;16(26). Available from: PubMed PMID: 21745444. [Google Scholar]

Ryan MA, Christian RS, Wohlrabe J. Handwashing and respiratory illness among young adults in military training.. Am J Prev Med 2001;21(2):79-83. Available from: PubMed PMID: 11457626. doi: 10.1016/S0749-3797(01)00323-3. [Google Scholar]

Cowling BJ, Chan K, Fang VJ, Cheng CKY, Fung ROP, Wai W, et al. Facemasks and hand hygiene to prevent influenza transmission in households: a cluster randomized trial.. Ann Intern Med 2009 Aug;151(7):437-446. Available from: PubMed PMID: 19652172. [Google Scholar]

Prevention, f.D.C.a. (Centers) . Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2015–16 Influenza Season. MMWR 2015;64(30):818-825. [Google Scholar]

European Centre for Disease Prevention and Control. Influenza vaccination. Available at:

Eurostep. The Lisbon Treaty. Art 168. Available at:

Council of the European Union. Council conclusions on Childhood immunisation: successes and challenges of European childhood immunisation and the way forward. 2011. Available at:

Council of the European Union. Council conclusions on vaccinations as an effective tool in public health. 2014. Available at:

Council of the European Union. Council recomendation on seasonal influenza vaccination. 2009. Available at:

VENICE. Vaccine European New Integrated Collaboration Effort. The Project. Available at:

I_MOVE Project. I-MOVE in Europe. Available at:

Valenciano M, Ciancio B, , team, s. (I-MOVE) . I-MOVE: a European network to measure the effectiveness of influenza vaccines. Euro Surveill 2012;17(39):20281. Available from: PubMed PMID: 23041022. [Google Scholar]

Valenciano M, Kissling E, Cohen J, Oroszi B, Barret A, Rizzo C, et al. Estimates of pandemic influenza vaccine effectiveness in Europe, 2009-2010: results of Influenza Monitoring Vaccine Effectiveness in Europe (I-MOVE) multicentre case-control study.. PLoS Med 2011 Jan;8(1). Available from: PubMed PMID: 21379316. doi: 10.1371/journal.pmed.1000388. [Google Scholar]

Lopalco PL, DeStefano F. The complementary roles of Phase 3 trials and post-licensure surveillance in the evaluation of new vaccines.. Vaccine 2014 Nov;33(13):1541-1548. Available from: PubMed PMID: 25444788. doi: 10.1016/j.vaccine.2014.10.047. [Google Scholar]

EMA. Eudravigilance, pharmacovigilance in the European Ecoomic Area. Available at:

VAESCO. Vaccine Adverse Events Surveillance and Communication. Available at:

Dieleman J, Romio S, Johansen K, Weibel D, Bonhoeffer J, Sturkenboom M, , Group VCS. Guillain-Barre syndrome and adjuvanted pandemic influenza A (H1N1) 2009 vaccine: multinational case-control study in Europe. BMJ 2011;343. Available from: PubMed PMID: 21750072. doi: 10.1136/bmj.d3908. [Google Scholar]

Romio S, Weibel D, Dieleman JP, Olberg HK, de Vries CS, Sammon C, et al. Guillain-Barré syndrome and adjuvanted pandemic influenza A (H1N1) 2009 vaccines: a multinational self-controlled case series in Europe.. PLoS One. Available from: PubMed PMID: 24404128. doi: 10.1371/journal.pone.0082222. [Google Scholar]

Nohynek H, Jokinen J, Partinen M, Vaarala O, Kirjavainen T, Sundman J, et al. AS03 adjuvanted AH1N1 vaccine associated with an abrupt increase in the incidence of childhood narcolepsy in Finland.. PLoS One 2012 Mar;7(3):33536-10. Available from: PubMed PMID: 22470453. doi: 10.1371/journal.pone.0033536. [Google Scholar]

for Disease Prevention and Control. Narcolepsy in association with pandemic influenza vaccination (a multi-country European epidemiological investigation. Stockholm: ECDC; 2012. [Google Scholar]

EU Commission. Decision on serious cross-border threats to health. 2013. Available at