Vaccine
Volume 33, Issue 38, Pages 4737-5026 (11 September 2015)
http://www.sciencedirect.com/science/journal/0264410X/33/38

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Dutch influenza vaccination rate drops for fifth consecutive year
Original Research Article
Pages 4886-4891
Margot A.J.B. Tacken, Birgit Jansen, Jan Mulder, Stephen M. Campbell, Jozé C.C. Braspenning
Abstract
Aim
To determine the prevalence and trend of the influenza vaccination-rate of the overall target population in the period 2008–2013, with a specific focus on groups at risk such as patients with cardiovascular diseases, lung diseases, diabetes and aged 60 years and older.
Methods
In an observational longitudinal study electronic medical records data from the Dutch representative network of general practices, LINH, were analyzed. For each influenza vaccination season, 2008–2013, the number of vaccinated and unvaccinated patients at risk are compared by chi-square tests (χ2) for linear trends, linear-by-linear association. The level of significance was set at p < 0.001 based on the large number of available records.
Results
The influenza vaccination rate of the overall at risk group decreased significantly from 71.5% in the 2008 season, to 59.6% in the 2013 vaccination season. The difference of 11.9% was gradual over the years, with a mean decrease of 2.4% per year. The decrease was seen in all specified groups at risk, but was mainly among patients aged 60–65 years (mean yearly decrease of 3.3%).
Conclusion
For the fifth subsequent year, we notice a lowering trend of the influenza vaccination rate in the population at risk. Reports in the mass media on questioning the effectiveness of the vaccination program may have been an influence; as well as the relatively light outbreaks of influenza in the past years, which may have affected the sense of urgency. The gradual decrease in vaccination rates over recent years requires further research and a public health debate is needed on the usefulness and necessity of the vaccination program.