Disparities in Seasonal Influenza Vaccination in Europe

Seasonal influenza remains a major public health challenge in Europe, associated with high morbidity, mortality, and socioeconomic burden. Despite the proven efficacy and cost-effectiveness of vaccination, coverage rates vary substantially across European countries and population groups, often falling short of the World Health Organization's target of 75% for older adults.

This narrative review aims to identify and explore disparities in seasonal influenza vaccination coverage across European countries and among different population subgroups. It also seeks to examine the underlying causes of these disparities and propose actionable strategies to improve equity in vaccine uptake.

A literature search was conducted using the PubMed database for English-language articles published within the last 5 years. Keywords included: comorbidity, disparity, Europe, inequality, influenza, knowledge, ethnic disparity, seasonal influenza vaccination, socioeconomic disparity, vaccination coverage, and vaccine hesitancy. Additional references were identified from the retrieved articles.

Widespread disparities in influenza vaccination were observed across various demographic and professional groups. These included disparities by geographic location, ethnicity, socioeconomic status, sex and gender, age, comorbidities, and occupation-particularly among healthcare professionals. Contributing factors included limited knowledge or education, negative attitudes or behaviors toward vaccination, vaccine hesitancy and fatigue, and restricted access to vaccination services. Structural barriers and institutional trust issues also played key roles.

Addressing disparities in influenza vaccination coverage in Europe requires multi-level, stakeholder-specific strategies. These should include education campaigns, improved access through alternative delivery settings (e.g., pharmacies, schools), targeted communication to high-risk and underserved populations, and systemic changes to support healthcare providers. Tackling these issues will help reduce preventable morbidity and mortality, enhance herd immunity, and foster healthier ageing across European populations.