Prioritization strategies for pandemic influenza vaccine in 27 countries of the European Union and the Global Health Security Action Group: a review

Straetemans, Masja; Buchholz, Udo; Reiter, Sabine; Haas, Walter; Krause, Gérard

doi:10.1186/1471-2458-7-236

Table 1 Establishment of Vaccine Priority Groups in EU^A and GSHAG^B countries

From: Prioritization strategies for pandemic influenza vaccine in 27 countries of the European Union and the Global Health Security Action Group: a review

Countries	Source(s) data abstraction included in this review			No. of main groups	Presence of list of subgroups within 3 main groups (Table 2)	Ranking of groups	Ethic committees/consultant involved	Intention to vaccinate whole population^C	Pandemic vaccine priority groups^D
	Pandemic plan	Email fax	Phone						(1) Healthcare workers	(2) Essential service providers	(3) High risk individuals	(4) Healthy adults and children^E	Other (Table 3) ^F
AT^A	yes	yes	yes	3	no^1a	no	yes^1b	yes	yes	yes	yes	no	no
BE^A	yes	yes	yes	discussion	not applicable	not applicable	no	unknown
BG^A	yes	yes	no	3	yes	yes	no^I	yes³	yes	yes	yes	yes	no
CA^B,2	yes	yes	no	5^H	yes	yes	no^I	yes	yes	yes	yes	yes	no
CY^A	no^G	yes	no	5^H	unknown	yes	yes	yes	partly⁴	yes	yes	yes	no
CZ^A,	yes	yes⁵	no	3	yes	unknown	unknown	unknown	yes	yes	yes	no	no
DK^A,6	yes	yes	yes	7^H	yes	yes, 2 groups⁶	no	yes	yes	yes	yes	yes^J	no
EE^A	yes	yes	no	3	yes	yes	no^I	yes	yes	yes	yes	partly^K	yes
FI^A,7	no^G	yes	no	1⁷	unknown	yes, 1 group⁷	yes	yes	yes⁷	no⁷	no⁷	no	no
FR^A,B,8	yes	yes	yes	3	no	no	no	unknown	yes	yes	yes	no	no
DE^A,B	yes	yes	yes	2^9a	no^9b	yes	no	yes	yes	yes	no	no	no
GR^A,10	yes	yes	no	5¹⁰	unknown	discussion¹⁰	yes	unknown	yes¹⁰	yes¹⁰	yes¹⁰	no	yes¹⁰
HU^A	yes	yes	no	3	no	yes	no	yes	yes	yes	yes	no	no
IE^A	yes	yes	no	7^H	yes	yes	no^I	yes	yes	yes	yes	yes^J	yes
IT^A,B	yes	yes	no	6^H	yes	yes	no	yes	yes	yes	yes	yes	yes
JP^B,11	yes	yes	yes	6^H	discussion	discussion	no	yes	yes	yes	yes	yes	yes
LV^A,12	no^G	yes	no	0¹²	not applicable	not applicable	unknown	unknown
LT^A,13	yes	yes	no	4	yes	discussion	no	yes	yes	yes	yes	no	no
LU^A	yes	no	yes	0	not applicable	not applicable	unknown	unknown
MT^A	no^14a	yes	no	8^H14b	no	yes	no	yes	yes	yes	yes	yes	yes
MX^B,15	no^G	yes	no	0	not applicable	not applicable	yes	unknown
PO^A,16	yes	yes	no	2	yes	no	unknown	unknown	yes	yes	yes	partly^K	no
PT^A	no^G	yes	no	discussion	unknown	discussion	yes	yes
RO^A	no^G	yes	no	5	yes	yes	yes	unknown	yes	yes	yes	partly^K	yes
SK^A	yes	yes	no	4	yes	no	no	unknown	yes	yes	yes	no	yes
SI^A	no^G	yes	no	4	no	yes	no^I	unknown	yes	yes	yes	partly^K	no
ES^A	yes	yes	no	4^H	discussion	yes	no	discussion	yes	yes	yes	yes	no
SE^A	yes	yes	no	7^H	no	no	yes	yes	yes	yes	yes	yes	yes
NL^A	yes	yes	yes	4^H	yes	yes	no	yes	yes	no	yes	yes	no
UK^A,B,17	yes	yes	no	7^H	yes	yes	yes	yes	yes	yes	yes	yes^J	yes
US^B,18	yes	no	yes	4^H	yes	yes	yes	yes	yes	yes	yes	yes	yes
Summary	23/31 (74%)	29/31 (94%)	9/31 (29%)	26/31 (84%)	14/26 (54%)	17/26 (65%)	10/31 (32%)	19/31 (61%)	26/26 (100%)	24/26 (92%)	24/26 (92%)	13/26 (50%)	11/26 (42%)

^A Member State of European Union (EU); ^B Member of Global Health Security Action Group (GSHAG); ^C 'yes'indicates that either National Pandemic Plan specifically reports the aim to vaccinate whole population and/or National Pandemic Plan includes 'healthy adults and children' as one of the vaccine priority group(s) and/or country representatives specifically reported this information; 'discussion' indicates country representative specifically reported that vaccination policy is still under discussion, 'unknown' indicates that this item is not specifically reported; ^D The issue of prioritisation arises only in the situation of vaccine shortage or when vaccines become available over time; ^E 'yes refers to those countries either specifying 'healthy adults and children' as vaccine priority group(s) and those countries reporting 'offer to all' as vaccine priority group; ^F Vaccine priority groups that could not be categorized in the four most common vaccine priority groups as described in this table; ^G National Pandemic Plan available in public domain in language other than English, Danish, Dutch, French, German or Swedish; ^H Including a category referring to vaccination of whole population; ^I Ethics considerations will be involved in the future; ^J Included under the vaccine priority group 'offer to all'; ^K Countries have included 'children' under 'high risk individuals'
^1a (AT) National Pandemic Plan serves as a framework to guide each of the nine states to develop specific plan including vaccine priority subgroups; ^1b No specific ethical committee involved but ethical considerations have been involved;
² (CA) Advancements in knowledge and technology are currently being considered by the Pandemic Vaccine Working group and may result in the revision of vaccine priority groups in updated Pandemic Plan in 2007
³ (BG) Specified in draft national influenza preparedness plan of Bulgaria as "aim is to cover gradually the maximum part of the population";
⁴ (CY) Specified as people working in the Health Sector involved with the distribution of vaccines and antivirals;
⁵ (CZ) Information received by email is from the unpublished National Pandemic Plan of the Czech Republic 2006;
⁶ (DK) Prioritisation of vaccine strategies will be decided during the course of a pandemic, the information in the table reflects the discussion paper in the pandemic plan;
⁷ (FI) Irrespective of the virus one vaccine priority group is determined in advance;
⁸ (FR) Working groups are updating strategies using pre-pandemic modelling but also accurate survey of the population and age-groups most affected by virus, associated with models of progressive availability of the vaccine in relation with the kinetics of a pandemic will determine the vaccine priority groups;
^9a (DE) Two main vaccine priority groups have been determined, discussion related to criteria of establishing further vaccine priority groups are under discussion ^9b National Plan serves as a framework to guide each of the 16 states to develop specific plan including vaccine priority subgroups.
¹⁰ (GR) Is in the process of discussing and further refining vaccine priority groups, the information in the table includes "suggested priority groups" as published in National Pandemic Plan;
¹¹ (JP) Prioritisation is under discussion and the table includes information in draft guidelines available for public discussion and comments;
¹² (LV) Influenza Pandemic Preparedness Plan of Latvia will be updated in 2007;
¹³ (LT) Vaccine priority groups will be revised in the "near future" [as of October 26^th 2006];
^14a (MT) National Influenza Pandemic Standing Committee has decided on vaccine priority groups and currently the plan prepared by this committee is being approved and amended by the Director General; ^14b Seven of eight reported vaccine priority groups have been categorized under four main categories included in this table;
¹⁵ (MX) Current National Preparedness and Response Plans does not include a scenario in which pandemic vaccine is available; this aspect may be updated as information on vaccine production and availability becomes available.
¹⁶ (PL) More specific and detailed strategy under discussion;
¹⁷ (UK) Plan is currently under revision, including more modelling of immunisation strategies;
¹⁸ (US) Revision of order prioritisation of tiers is expected in spring 2007.

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ISSN: 1471-2458

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