Review Article
ADVICE for a healthier life: Adult Vaccination Campaign in Europe

https://doi.org/10.1016/j.ejim.2016.04.021Get rights and content

Highlights

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    Adults and elderly do need vaccines within a lifelong immunization schedule.

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    Communicable diseases are on the rise with aging population, globalization and immunity gaps.

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    Data for adult vaccination rates in Europe is incomplete. There are no targets except for influenza.

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    There is a lack of international consensus on adult vaccination guidelines on a European basis.

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    ‘ADVICE’ is Europe wide initiative of EFIM to raise awareness of adult vaccination.

Abstract

Immunization is one of the most effective public health measures to prevent disease. Despite relatively good vaccination rates in childhood in many parts of the world, vaccines to prevent diseases are underused in the adult population and adult vaccination rates are still far below the target. The European Federation of Internal Medicine (EFIM), declared that ‘internal medicine must focus on better care for individuals, better health care for populations and lower costs’. Adult vaccination is a good example of a public health initiative aimed at reducing morbidity and mortality, but awareness of the need for adult vaccination and uptake of the programs across Europe is variable. The Adult Vaccination Campaign in Europe (ADVICE) was developed with an aim to raise awareness for adult vaccination and to understand the dynamics of the vaccination practices and the possible barriers against achieving targeted vaccination rates in Europe. In order to reach vaccination targets, we need evidence based, up to date guidelines; recommendations at national and international levels; surveillance for vaccination rates; and opportunities to provide vaccines more readily. Leadership at a European level and a firm research and action agenda are crucial. The European Federation of Internal Medicine can take the lead as it declared its interest on ‘better care for individuals, better health care for populations’. Hence, we consider ADVICE a very timely and very valuable initiative to draw a roadmap to improve adult vaccination rates in Europe.

Section snippets

Introduction: why is adult vaccination important?

Immunization is one of the most effective public health measures to prevent disease. It has eradicated smallpox, lowered the global incidence of polio so far by 99%, and achieved dramatic reductions in illness, disability and death from diphtheria, tetanus, whooping cough and measles. In 2003 alone, it is estimated that immunization averted more than 2 million deaths in children [1]. However, despite relatively good vaccination rates in childhood in many parts of the world, vaccines to prevent

Aging population and immunosenescence

Projections indicate that by 2025–2030, the population over 60 years of age will be growing 3.5 times as rapidly as the total population [17]. Europe is currently the world's major area with the highest proportions of older persons and this demography is projected to continue for at least the next 50 years. Similarly in other Western countries, 30–50% of the population will be over 65 years of age by 2040 [18]. In the US, it is estimated that 70,000 adults die of VPDs while 200 children die of

Vaccine coverage rates and targets

Lack of vaccination coverage data is an obstacle to improve vaccination strategies for a country [32]. Vaccination coverage assessment and surveillance of VPDs are important parameters for improving vaccination strategies and evaluating the progress of immunization programs [42]. Data for adult vaccine coverage rates in European countries is incomplete and there are no targets except for influenza. In December 2009, the European Council unanimously recommended that EU countries adopt and

Barriers and opportunities for improvement

In this new era, we need to urgently address the challenge of adult vaccination to ensure it becomes part of routine immunization. All countries should undertake programs to increase immunization coverage among adults. Barriers against effective life-long vaccination should be highlighted and each one of these barriers at each level (i.e., organizational, healthcare provider, patient, healthcare system, stakeholders, industry and logistics) should receive special attention (Table 4). More

‘ADVICE’ — a Europe wide initiative to raise awareness of adult vaccination

One of the barriers to an effective lifelong vaccination strategy is lack of leadership. Strong leadership at each and every level of the healthcare system and society will be a critical component in achieving adult vaccination targets. The European Federation of Internal Medicine (EFIM), declared that ‘internal medicine must focus on better care for individuals, better health care for populations and lower costs’ [54]. Adult vaccination is a good example of a public health initiative aimed at

Conclusion

In order to reach vaccination targets, we need evidence based, up to date guidelines; recommendations at national and international levels; surveillance for vaccination rates; and opportunities to provide vaccines more readily. Leadership at a European level and a firm research and action agenda are crucial. The European Federation of Internal Medicine can take the lead as it declared its interest on ‘better care for individuals, better health care for populations’ [54]. Hence, we consider

Learning points

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    The burden of communicable diseases and mortality from vaccine preventable diseases are on the rise with the aging population, globalization and immunity gaps.

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    In this new era, we must direct our efforts toward preventing communicable diseases affecting adults, and more globally toward a life-long immunization program for overall improvement in public health.

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    Barriers against effective life-long vaccination should be highlighted and each one of these barriers at each level (i.e., organizational,

Conflicts of interest

There is no conflict of interest related to this article.

Acknowledgment

This manuscript is written by the members of the European Federation of Internal Medicine Adult Vaccination Campaign in Europe (ADVICE) Working Group.

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    © 2016 Published by Elsevier B.V. on behalf of European Federation of Internal Medicine.