Frederic Bouder, PhD, is Professor in Risk Management at The Centre for Risk Management and Societal Safety (SEROS), University of Stavanger, Norway. SEROS is one of the main hubs of risk research in the world with over 40 researchers and 30 PhD students studying risk. He is a recognised expert in risk policy analysis and has deployed this expertise to develop and maintain international policy networks. His awareness of the role that new modes of governance and the media play in pharmaceutical policy making has made health risk communication a central pillar of his research. He has integrated cognitive insights from decision science into making risk policy more science-informed. He is directing research on genetic risk communication, as part of the multi-partner project MindTheRisk supported by the Swedish Social Science Foundation. He is also engaged in a productive research collaboration with senior colleagues at the King’s Centre for Risk Management, King’s College London.
Understanding the Public Perception of Influenza Vaccines During the COVID-19 Pandemic and Awareness of New Public Health Policy Decisions May Mitigate a Potentially High Severity 2020-2021 Influenza Season
Dr. S Rajaram currently serves as a Global Head of Medical Strategy, Seqirus and is responsible for the seasonal, pandemic and pipeline influenza vaccines at Seqirus.
Previously, he worked as a Global Medical Affairs Lead in Medimmune/AstraZeneca responsible for the RSV pipeline, influenza monoclonal antibody pipeline and influenza vaccines. Prior to that, he worked at GSK in paediatric vaccines as the country medical lead in the UK.
He qualified as a medical doctor from India and worked extensively in the UK in paediatrics for 10 years to complete his clinical career as a consultant in paediatrics in the NHS in the UK. He also has an MBA from Warwick Business School and Membership of Royal College of Paediatrics and Faculty of Pharmaceutical Medicine from the UK.
Frederic Bouder, University of Stavanger
Sankrasubramanian Rajaram, Head of Global Medical Strategy, Seqirus, United Kingdom
The COVID-19 experience contains many valuable lessons for researchers, practitioners, vaccine manufacturers, and policy holders involved in influenza control. Although caused by different pathogens, COVID-19 and influenza share many clinical features, including similar respiratory and other symptoms as well as the potential for inflammatory, cardiovascular, and other long-term complications. High rates of infection, severe disease, and deaths with COVID-19 have challenged healthcare systems worldwide, and in the upcoming season threatens to further strain resources. During the 2020-2021 influenza season, COVID-19 mitigation efforts and a robust influenza vaccination campaign led to an unprecedented reduction in influenza cases worldwide. However, the lack of exposure to influenza may have reduced population immunity to influenza and set the stage for a high severity influenza season in 2021-2022. Now, over 18 months into the COVID-19 pandemic, it is critical to re-evaluate contemporary public perception and emerging government policy to facilitate effective communication regarding the importance of influenza immunization and vaccine selection for frontline providers and the public. These learnings may optimize health administration and deployment as the COVID-19 pandemic is compounded by influenza during the coming fall and winter and provides a proactive strategy for preventing large numbers of severe influenza cases with potential to overwhelm an already burdened healthcare system. To explore current perceptions and future acceptance of influenza vaccine during the pandemic a new survey of 5,911 older (50+) adults over eight European countries was conducted that provides new insight into how flu and Covid-19 vaccines were perceived in mid-2021. In the United Kingdom, new influenza vaccines have resulted in the Joint Committee on Vaccination and Immunisation recommending age-based policy recommendations and use of cell-based vaccines preferentially over traditional egg-based vaccines – an emergent policy implemented by the Department of Health. Pandemic influenced core beliefs and learnings regarding the efficacy of influenza vaccine, and awareness of new public health policy decisions regarding vaccine selection dually impact the potential reduction of disease burden and may mitigate a pandemic influenced high severity influenza season.
Understanding the variability of risk preferences for influenza vaccination among older adults (50+) during Covid19 times: a 8-country survey.
Too little is known about how the post-pandemic environment will affect uptake of influenza vaccination among older people. Yet, the Covid-19 pandemic and related containment measures are affecting perception and behaviour in relation to influenza vaccination. Will Covid-19 increase or decrease influenza vaccination acceptance? This new survey of 5,911 older (50+) adults over eight European countries conveys new insights into how flu and Covid-19 vaccines were perceived in mid-2021. The study confirms that people generally fear Covid-19 more than the flu, and that they continue to rank the flu as a moderate risk. Compared to data collected in 2019 in four of our eight countries, people have increased their perception of the benefit of the flu vaccine while decreasing their perception of the negatives. Age variations were also observed. In this respect, the findings revealed: (1) clear relevance of age and country in shaping influenza vaccination behaviour, (2) that vaccination behaviour is easier to predict for older adults, (3) that “older older” adults vaccinate far more regularly than “younger older” adults, (4) and that some core beliefs about the efficacy of influenza vaccines are centrally important in influencing vaccination behaviour across age groups and countries.
In the UK, the Department of Health (DH) is advised by the Joint Committee on Vaccination and Immunisation (JCVI), an independent expert advisory committee. JCVI makes recommendations on vaccination policy and schedules after considering disease epidemiology, vaccine efficacy, vaccine safety and cost-effectiveness of implementing a programme1.
Prior to the Covid-19 pandemic, the winter burden of the NHS was dominated by influenza and other respiratory diseases in seniors (>65 years age). Influenza vaccine schedule was reviewed in 2017-18 based on the previous seasons when H3N2 vaccine effectiveness (VE) was on a downward trend (<30%) and was causing major winter burden in the National Health Service (NHS).2-4 Therefore, JCVI reviewed the schedule in light of newly available adjuvanted influenza vaccine (and since then an alternative option such as High Dose) and introduced a separate vaccine for older adults in over 65 years age group. Additionally, cell-based vaccines (QIVc and QIVr) are now recommended above the traditional egg based standard influenza vaccines.5
New influenza vaccines which allow age-based recommendations has opened the possibility of reducing disease burden. There is improved vaccine effectiveness according to PHE reports and this is continuing to be a key pillar during the COVID-19 pandemic. There are learnings available for other countries from the UK experience.
- Atchison CJ, Hassounah S. The UK immunisation schedule: changes to vaccine policy and practice in 2013/14. JRSM Open. 2015;6(4):2054270415577762. Published 2015 May 11. doi:10.1177/2054270415577762
- Influenza vaccine effectiveness in adults and children in primary care in the UK: provisional end-of-season results 2015-16 [Internet]. Public Health England. [cited 23 September 2021]. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/779476/Influenza_vaccine_effectiveness_in_primary_care_2015_2016.pdf
- Influenza vaccine effectiveness (VE) in adults and children in primary care in the United Kingdom (UK): provisional end-of-season results 2016-17 [Internet]. Public Health England. [cited 23 September 2021]. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/779475/Influenza_vaccine_effectiveness_in_primary_care_2016_2017.pdf
- Influenza vaccine effectiveness (VE) in adults and children in primary care in the United Kingdom (UK): provisional end-ofseason results 2017-18 [Internet]. Public Health England. [cited 23 September 2021]. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/779474/Influenza_vaccine_effectiveness_in_primary_care_2017_2018.pdf
- Joint Committee on Vaccination and Immunisation [Internet]. GOV.UK. 2021 [cited 23 September 2021]. Available from: https://www.gov.uk/government/groups/joint-committee-on-vaccination-and-immunisation