In Romania, influenza vaccination coverage remained far below the recommendations of the World Health Organization (WHO), which aims at a rate of 75% among vulnerable populations.
In the 2023-2024 flu season, according to data from the National Center for Communicable Disease Surveillance and Control, less than 6% of the general population was vaccinated, down from the previous season. The situation is even more worrying for people aged over 65, where vaccination coverage was only 19.6%, significantly lower than the target set by the WHO[1]. In this context, differentiated influenza vaccination becomes essential to provide effective protection to people at increased risk of severe complications. Dr. Lidija Milicevic, Head of Vaccines Sanofi Romania, explains why the vaccination strategy adapted for vulnerable categories is the key to protecting public health and preventing hospitalizations caused by influenza.
Seasonal influenza continues to be a severe respiratory disease with the potential to cause dangerous complications, especially for the elderly or patients with chronic conditions. In Romania, statistics indicate an alarming rate of hospitalizations and deaths among these vulnerable groups. For example, in the 2023-2024 flu season, we had an increased number of flu cases, worryingly the fact that most deaths, namely 71 out of 101, were among people over 65 years old1. Prevention by vaccination is the most effective protection measure.
“Flu is not just a common infection, it can cause serious complications, including exacerbation of chronic diseases. It is important to understand that the flu does not affect everyone the same. Therefore, differentiated influenza vaccination is key to protect groups most at risk of severe complications, such as the elderly and patients with chronic diseases. For these categories, the risk of hospitalization and even death is much higher compared to the rest of the population, and a vaccination strategy adapted to each need can make the difference between life and death,” explains Dr. Lidija Milicevic, Head of Vaccines Sanofi Romania.
The devastating impact of influenza on the elderly
For the elderly, the flu does not mean just a few days of fever and cough, but can lead to complications such as pneumonia, respiratory failure or even myocardial infarction or stroke. This is attributed to a weakened immune system caused by immunosenescence and frailty that occur with age[2]. Also, the elderly often have comorbidities that make them more vulnerable to influenza and its associated complications, including hospitalizations for cardiovascular events and pneumonia[3][4].
Data shows two-thirds of flu hospitalizations globally involve people over 65[5]. And only
1 in 3 people over the age of 70, hospitalized with an acute infection such as the flu, fully recover after 1 year[6].
Furthermore, influenza and its complications can lead to functional decline and loss of autonomy in the elderly. 3 out of 20 people experience severe persistent disability that can lead to long-term institutionalization in nursing homes17.
“For the elderly, the flu is much more than just a cold. Due to the natural weakening of the immune system with age, they are much more at risk of severe complications such as pneumonia or cardiovascular disease. A flu infection can destabilize the fragile balance of their health, and recovery is often difficult and lengthy. In addition, the flu can have a major impact on their ability to remain independent,” explains Dr. Milicevic. “Differentiated vaccination, with a vaccine with a high dose of antigens, provides increased protection and can prevent these serious complications, helping them maintain their quality of life.”
Chronic patients, vulnerable to the flu
In addition to the elderly, people with chronic conditions represent another category at risk. People with diabetes, cardiovascular disease, or respiratory conditions are at a much higher risk of developing serious complications if they contract the flu virus. The flu can worsen these pre-existing conditions, leading to hospitalization or even death.
Studies have shown that in the first three days after a flu infection, an adult over 40 is 8 times more likely to have a stroke and 10 times more likely to have a heart attack[7]. After a flu infection, 74% of patients with diabetes have elevated glycemic values. Influenza can also worsen asthma symptoms and trigger exacerbations, even in mild or well-controlled cases[8] [9].
“For these people, vaccination is crucial. The World Health Organization (WHO) recommends a vaccination coverage of 75% for vulnerable categories, but, unfortunately, Romania has not yet reached this goal,” emphasizes Dr. Lidija Milicevic. “In Romania, the major challenge is related to increasing the vaccination rate, which remains below the European average. This makes certain segments of the population, especially the elderly and people with chronic illnesses, much more exposed to severe flu complications. There is also persistent misinformation among the public, which contributes to mistrust of vaccines. Each flu season, we focus on educating the public and facilitating access to vaccines. People need to understand the importance of not only protecting their own health, but also those around them – the community as a whole benefits when vaccination rates increase,” she added.
Differential vaccination, an essential step for protection
The World Health Organization and other public health institutions strongly recommend influenza vaccination for people in risk groups, and Sanofi Romania supports these efforts by providing innovative vaccines and through awareness campaigns aimed at the general public. Influenza vaccines must not only prevent infection with the flu virus, but also protect beyond the flu itself against its severe complications, such as pneumonia, heart attack, and stroke. With the rapid evolution of technology, the future of flu vaccines is shaping up to be extremely promising.
“We are constantly investing in the development of vaccines that better respond to the specific needs of the population. For example, new technologies allow us to adapt vaccines to cover a wider spectrum of influenza strains, which improves the protection provided by our vaccines. In addition, we are working to make vaccination more accessible and easier. All these innovations aim to improve public health and reduce the impact of influenza on the health system,” says Dr. Milicevic.
In the context where Romania has an aging population and an already overcrowded medical system, vaccinating people from the risk categories becomes a priority to prevent severe cases and reduce the burden on hospitals.
“Let’s not underestimate the flu! It is a disease that can have very serious consequences, especially for the vulnerable. Whether we are talking about the elderly or chronic patients, vaccination is not only a means of individual protection, but also a collective protection tool. The more of us who get vaccinated, the more we reduce the circulation of the virus and protect the community. It’s a simple gesture, but one that can save lives,” she says.
“Regardless of age or health, it’s important to protect ourselves and those around us. With the help of differentiated vaccination, we can adapt everyone’s protection to their specific needs, which is a major step in the direction of better public health,” concludes Dr. Lidija Milicevic.
[1] CNSCBT – Analysis of the evolution of influenza, acute respiratory infections (ARI) and severe acute respiratory infections (SARI) in the 2023-2024 season
[2] Centers for Disease Control and Prevention. Accessed in: September 2024
[3] Center for Disease Control and Prevention. Study shows hospitalization rates and risk of death from seasonal flu increase with age among people 65 and older: https://www.cdc.gov/flu/spotlights/2018-2019/hopitalization-rates-older.html. Accessed 09/19/2023
[4] Center for Disease Control and Prevention. People at high risk for flu complications: Accessed 09/19/2023
[5] CDC.
Epidemiology and Prevention of Vaccine-Preventable Diseases. Hamborsky J,
Kroger A, Wolfe S, eds. 13th ed. Washington DC: Public Health Foundation; 2015
[6] Boyd CM,
et al. J Am Geriatr Soc. 56(12):2171-2179 (2008)
[7] Warren-Gash C, Blackburn R, Whitaker H et al. Laboratory-confirmed respiratory infections as triggers for acute myocardial infarction and stroke: a self-controlled case series analysis from Scottish national data sets. Eur Respir J. 2018; 51(3):1701794
[8] Center for Disease Control and Prevention. Flu and people with asthma. 2019; Available at https: www.cdc.gov/flu/highrisk/asthma.htm
[9] Schwarze, J., Openshaw, P., Jha, A., Del Giacco, SR, Firinu, D., Tsilochristou, O., … & Skevaki, C. (2018). Burden of influenza, prevention and treatment in asthma – A review by the EAACI Influenza in Asthma Working Group. Allergy, 73(6), 1151-1181
Flu Vaccination Breakdown: Romania’s Struggle
Ah, Romania! A land known for its stunning landscapes and heartwarming folklore—what it could really use right now, apparently, is a little bit of flu vaccine enthusiasm. You heard that right! It appears that the influenza vaccination coverage there isn’t just below WHO recommendations; it’s practically doing the limbo under them!
The Numbers Don’t Lie
In the 2023-2024 flu season, little 6% of the general population rolled up their sleeves to receive the vaccine, dropping from a pitiful previous season score. For the elderly, that coverage alarmingly clocked in at a mere 19.6%. I mean, come on, that’s barely enough to qualify as a party! But in this case, it’s a missing invite to a life-saving event.
Dr. Lidija Milicevic from Sanofi Romania points out that every flu season, we face an educational challenge. It’s like trying to convince cats to take a bath—lots of resistance! But fear not; engaging the public on the importance of vaccination can gradually turn the tide. Remember, folks: a well-informed community is worth its weight in gold—or at least in vaccines!
The Devastating Impact of Flu on the Elderly
For our beloved seniors, the flu can often turn into a sequel to a horror movie—think “The Exorcist”, but instead of a little girl spinning her head around, it leads to complications like pneumonia, respiratory failure, or even a heart attack. Seriously, not what you want to put in your bingo night plans.
Statistics reveal two-thirds of flu-related hospitalizations globally involve individuals over 65. You might want to start placing bets on the wrong side of that statistic—it’s not looking good! Only one in three people over 70, who are hospitalized with acute infections, actually doesn’t call the nursing home ‘home’ after a year. Talk about a flu-inflected retirement plan!
Chronic Patients: Another Tough Crowd
Then, you have the other at-risk category: those with chronic health conditions. Think diabetes, cardiovascular disease, or respiratory issues. They’re just sitting there, minding their business, and along comes the flu virus, ready to party crash their lives.
Did you know that within the first three days of contracting the flu, adults over 40 are eight times more likely to have a stroke? It’s like the flu is handing out VIP passes to health disasters—and nobody’s asking for them!
Vaccination: The Growing Need for Differentiation
In Romania, trying to hit that WHO target of 75% vaccination coverage for vulnerable populations feels like climbing up the wrong mountain. Dr. Milicevic emphasises that vaccination isn’t about being trendy; it’s about necessity. The more people vaccinated, especially among the elderly and those with chronic conditions, the safer we can make our communities. And let’s be real—nobody wants to be ‘that’ person who brings the flu back for a return visit.
We’ve got to tackle the misinformation that swirls around like those pesky flies at a summer picnic. Let’s make it our mission to educate and simplify access to vaccines. It’s not just about protecting ourselves; it’s about showing some love to our neighbors!
A Call to Arms—or Sleeves!
The message is clear: Let’s not underestimate the flu! Whether you’re young, old, or somewhere in between, vaccination goes beyond individual safety; it’s a collective armor against transmission. I mean, last I checked, we live in a society!
“With differentiated vaccination, we can tailor protection for those who need it most,” states Dr. Milicevic. This isn’t just a jab in the arm; it’s akin to a well-planned strategy that could keep our cherished elderly and chronic patients out of the hospital and enjoying life.
In conclusion, Romania, let’s shake things up! Roll up those sleeves, educate ourselves, and tackle the problem head-on. Next flu season, let’s aim for that 75%, not just because WHO says so, but because it’s the right thing to do. After all, a healthy community is a happy community. And let’s be honest, who doesn’t need a bit of happiness right now?
