BACKGROUND: By March, 2023, 54 countries, areas, and territories (hereafter CAT) in the WHO European Region had reported more than 2·2 million COVID-19-related deaths to the WHO Regional Office for Europe. Here, we estimated how many lives were directly saved by vaccinating adults in the WHO European Region from December, 2020, to March, 2023. METHODS: In this retrospective surveillance study, we estimated the number of lives directly saved by age group, vaccine dose, and circulating variant-of-concern (VOC) period, regionally and nationally, using weekly data on COVID-19 mortality and infection, COVID-19 vaccination uptake, and SARS-CoV-2 virus characterisations by lineage downloaded from The European Surveillance System on June 11, 2023, as well as vaccine effectiveness data from the literature. We included data for six age groups (25-49 years, 50-59 years, ≥60 years, 60-69 years, 70-79 years, and ≥80 years). To be included in the analysis, CAT needed to have reported both COVID-19 vaccination and mortality data for at least one of the four older age groups. Only CAT that reported weekly data for both COVID-19 vaccination and mortality by age group for 90% of study weeks or more in the full study period were included. We calculated the percentage reduction in the number of expected and reported deaths. FINDINGS: Between December, 2020, and March, 2023, in 34 of 54 CAT included in the analysis, COVID-19 vaccines reduced deaths by 59% overall (CAT range 17-82%), representing approximately 1·6 million lives saved (range 1·5-1·7 million) in those aged 25 years or older: 96% of lives saved were aged 60 years or older and 52% were aged 80 years or older; first boosters saved 51% of lives, and 60% were saved during the Omicron period. INTERPRETATION: Over nearly 2·5 years, most lives saved by COVID-19 vaccination were in older adults by first booster dose and during the Omicron period, reinforcing the importance of up-to-date vaccination among the most at-risk individuals. Further modelling work should evaluate indirect effects of vaccination and public health and social measures. FUNDING: US Centers for Disease Control and Prevention.

• MeSH
• COVID-19 * prevention & control   mortality   epidemiology   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Immunization Programs statistics & numerical data   MeSH
• Retrospective Studies MeSH
• SARS-CoV-2 * immunology   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• World Health Organization MeSH
• COVID-19 Vaccines * administration & dosage   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Europe MeSH

• MeSH
• Health Services Accessibility statistics & numerical data   MeSH
• Pharmaceutical Preparations supply & distribution   MeSH
• Immunization Programs methods   statistics & numerical data   MeSH
• General Practice MeSH
• Primary Health Care * organization & administration   statistics & numerical data   MeSH
• Publication type
• Interview MeSH
• Geographicals
• Czech Republic MeSH

• MeSH
• Aedes MeSH
• Hepatitis C, Chronic epidemiology   prevention & control   MeSH
• COVID-19 epidemiology   MeSH
• COVID-19 Drug Treatment MeSH
• Disease Vectors MeSH
• Encephalitis, Tick-Borne epidemiology   MeSH
• Clostridium Infections epidemiology   MeSH
• Congresses as Topic MeSH
• Communicable Disease Control * MeSH
• Humans MeSH
• Listeriosis epidemiology   MeSH
• Infant, Newborn, Diseases MeSH
• Immunization Programs organization & administration   statistics & numerical data   MeSH
• Pemphigus epidemiology   MeSH
• Pneumococcal Infections prevention & control   MeSH
• Vaccination Coverage MeSH
• COVID-19 Serological Testing statistics & numerical data   MeSH
• Tularemia epidemiology   MeSH
• Check Tag
• Humans MeSH

Chřipka je onemocnění s významným populačním dopadem a očkování představuje nejefektivnější možnost prevence onemocnění. Zdravotníci jsou vzhledem k charakteru své profese ve vyšším riziku expozice respiračním patogenům (včetně chřipky) ve srovnání s obecnou populací. Očkováním chrání sebe a své blízké. Druhým důvodem očkování zdravotnického personálu je ochrana rizikových pacientů, protože zdravotníci mohou být zdrojem nozokomiálního šíření infekce. Očkování zdravotníků je doporučeno nejenom Světovou zdravotnickou organizací, ale i na národních úrovních. I přes dlouhodobá doporučení se v zemích Evropské unie proočkovanost zdravotníků pohybuje průměrně do 30 %, avšak s významnými rozdíly mezi jednotlivými zeměmi. Rozdíly jsou patrné i mezi jednotlivými zdravotnickými zařízeními a odděleními. Některá zařízení, regiony a státy (např. USA, Kanada) uplatňují strategii povinného očkování zdravotnických pracovníků, která se odráží ve vysoké míře proočkovanosti. Mezi základní důvody odmítání očkování se u zdravotníků řadí vnímání chřipky jako mírného onemocnění, nejistota ohledně účinnosti vakcinace a její bezpečnosti, strach z nežádoucích reakcí po očkování, údajný nedostatek času pro očkování a nedostupnost vakcinačních center. Strategie s pozitivním vlivem na nárůst očkování zdravotníků zahrnují podporu národních autorit, individuální edukační aktivity spojené se zdůrazněním chřipky jako významného onemocnění a se zdůrazněním významu a přínosu vakcinace, připomínání očkování, odstraňování administrativních bariér či očkování přímo v místech výkonu práce. Kombinované strategie jsou vždy efektivnější než izolované intervenční aktivity.

Influenza is a disease with a significant population impact. Vaccination is the most effective option for disease prevention. Healthcare workers are at higher risk of exposure to respiratory pathogens (including influenza) compared to the general population due to their profession. Vaccination can protect the health of healthcare workers and their relatives. The second reason for vaccinating medical staff is the protection of risk patients. Healthcare professionals can be a source of nosocomial spreading of infection. Vaccination is recommended not only by the World Health Organization, but also at national levels. In spite of long-term existence of recommendations, the flu vaccination coverage in healthcare workers in the European Union is up to 30% in average, but with significant differences between countries. Differences are also evident between individual medical facilities and departments. Some facilities, regions and states (such as the US, Canada) have a mandatory vaccination strategy for healthcare professionals. The policy is reflected in the high vaccination rate. The perception of influenza as a mild disease, the uncertainty about vaccine efficacy and safety, the fear of adverse reactions after vaccination, the alleged lack of time for vaccination and the unavailability of vaccination centres are among the basic reasons for rejecting vaccination among healthcare workers. Strategies with a positive impact on the increase of vaccination coverage in healthcare workers include support from national authorities, individual educational activities to highlight influenza as a severe disease and to highlight the importance and benefits of vaccination, reminding of vaccination, removing of administrative barriers and vaccinations at work site. Combined strategies are always more effective than isolated intervention activities.

• MeSH
• Influenza, Human * etiology   complications   prevention & control   MeSH
• Adult MeSH
• Humans MeSH
• Immunization Programs statistics & numerical data   trends   MeSH
• Vaccination Refusal statistics & numerical data   MeSH
• Vaccination Coverage statistics & numerical data   MeSH
• Vaccination MeSH
• Influenza Vaccines administration & dosage   MeSH
• Health Personnel MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Child MeSH
• Adult MeSH
• Mass Vaccination adverse effects   statistics & numerical data   legislation & jurisprudence   MeSH
• Compensation and Redress legislation & jurisprudence   MeSH
• Communicable Disease Control MeSH
• Humans MeSH
• Immunization Programs statistics & numerical data   legislation & jurisprudence   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Humans MeSH
• Publication type
• Newspaper Article MeSH

Seasonal influenza can have serious morbid consequences and can even result in death, particularly in at-risk populations, including healthcare professionals (HCPs), elderly and those living with a medical risk condition. Although in Europe recommendations exist for annual influenza vaccination in these populations in most countries, the vaccination coverage rate (VCR) is often well below the World Health Organization target of 75% coverage. In our previous survey in 2009 we showed that some elements of national vaccination policies, e.g. reminder systems, strong official recommendation, and easy access, seemed to contribute to achieving higher influenza VCRs among elderly. We repeated the survey in 2016, using the same methodology to assess changes in influenza VCRs among the elderly and in the impact of policy elements on these VCRs. In addition, we collected information about VCRs among HCPs, and those living with a medical risk condition. The median VCR in the 21 countries that had recommendations for influenza vaccination in the elderly was 35.3%, ranging from 1.1% in Estonia to 74.5% in Scotland. The average VCRs for HCPs and those living with medical risk conditions, available in 17 and 10 countries, respectively, were 28.3% (range 7% in Czech Republic to 59.1% in Portugal) and 32.2% (range from 20.0% in the Czech Republic and Hungary to 59.6% in Portugal), respectively. Fewer countries were able to provide data from HCP and those living with medical risk conditions. Since the initial survey during the 2007-2008 influenza season, VCRs have decreased in the elderly in the majority of countries, thus, achieving high VCRs in the elderly and the other target groups is still a major public health challenge in Europe. This could be addressed by the identification, assessment and sharing of best practice for influenza vaccination policies.

• MeSH
• Influenza, Human prevention & control   MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Immunization Programs organization & administration   statistics & numerical data   MeSH
• Vaccination Coverage statistics & numerical data   MeSH
• Child, Preschool MeSH
• Seasons MeSH
• Aged MeSH
• Pregnancy MeSH
• Health Policy * MeSH
• Health Plan Implementation organization & administration   statistics & numerical data   MeSH
• Check Tag
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Child, Preschool MeSH
• Aged MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Europe MeSH

BACKGROUND: The Streptococcus pneumoniae Invasive Disease network (SpIDnet) actively monitors populations in nine sites in seven European countries for invasive pneumococcal disease. Five sites use 13-valent pneumococcal conjugate vaccine (PCV13) alone and four use the ten-valent PCV (PCV10) and PCV13. Vaccination uptake is greater than 90% in six sites and 67-78% in three sites. We measured the effects of introducing high-valency PCVs on the incidence of invasive pneumococcal disease in children younger than 5 years. METHODS: We compared the incidence of invasive pneumococcal disease in each of the 4 years after the introduction of PCV13 alone or PCV10 and PCV13 with the average incidence during the preceding period of heptavalent PCV (PCV7) use, overall and by serotype category. We calculated incidence rate ratios (IRRs) and 95% CIs for each year and pooled the values for all sites in a random effects meta-analysis. FINDINGS: 4 years after the introduction of PCV13 alone or PCV10 and PCV13, the pooled IRR was 0·53 (95% CI 0·43-0·65) for invasive pneumococcal disease in children younger than 5 years caused by any serotype, 0·16 (0·07-0·40) for disease caused by PCV7 serotypes, 0·17 (0·07-0·42) for disease caused by 1, 5, and 7F serotypes, and 0·41 (0·25-0·69) for that caused by 3, 6A and 19A serotypes. We saw a similar pattern when we restricted the analysis to sites where only PCV13 was used. The pooled IRR for invasive pneumococcal disease caused by non-PCV13 serotypes was 1·62 (1·09-2·42). INTERPRETATION: The incidence of invasive pneumococcal disease caused by all serotypes decreased due to a decline in the incidence of vaccine serotypes. By contrast, that of invasive pneumococcal disease caused by non-PCV13 serotypes increased, which suggests serotype replacement. Long-term surveillance will be crucial to monitor the further effects of PCV10 and PCV13 vaccination programmes in young children. FUNDING: European Centre for Disease Prevention and Control, Czech National Institute of Public Health, French National Agency for Public Health, Irish Health Services Executive, Norwegian Institute of Public Health, Public Health Agency of Catalonia, Public Health Department of Community of Madrid, Navarra Hospital Complex, Public Health Institute of Navarra, CIBER Epidemiology and Public Health, Institute of Health Carlos III, Public Health Agency of Sweden, and NHS Scotland.

• MeSH
• Outcome Assessment, Health Care MeSH
• Incidence MeSH
• Infant MeSH
• Humans MeSH
• Immunization Programs statistics & numerical data   MeSH
• Pneumococcal Infections epidemiology   prevention & control   MeSH
• Pneumococcal Vaccines therapeutic use   MeSH
• Child, Preschool MeSH
• Streptococcus pneumoniae immunology   MeSH
• Check Tag
• Infant MeSH
• Humans MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Observational Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Europe epidemiology   MeSH

BACKGROUND: Invasive pneumococcal disease (IPD) is caused by Streptococcus pneumoniae and mostly presents as pneumonia, sepsis or meningitis. A notable portion of IPD cases is vaccine preventable and the pneumococcal conjugate vaccine (PCV) was introduced into the routine childhood immunization programs in many countries during the last decades. OBJECTIVES: Before PCV introduction in the Czech Republic in 2010, a national surveillance system for IPD was implemented in 2008 and further improved in 2011. In this study, we describe the new surveillance system for the first time and measure its sensitivity between 2010 and 2013 using the capture-recapture method. Furthermore, we describe the recent epidemiological trend of IPD, taking sensitivity estimates into account. RESULTS AND CONCLUSIONS: Between 2010 and 2013 the estimated sensitivity of the overall IPD surveillance increased from 81% to 99%. The sensitivity of individual reporting sources increased from 72% to 87% for the laboratory system and from 31% to 89% for the epidemiological notification system. Crucial for this improvement was the introduction of quarterly report reminders in 2011. Due to positive source dependency, the presented sensitivity estimates are most probably overestimated and reflect the upper limit of reporting completeness. Stratification showed variation in sensitivity of reporting particularly according to region. An effect of the PVC vaccination in the Czech Republic is visible in the incidence of IPD in target age groups (<5 y). This influence was not evident in the total IPD incidence and may interfere with increasing sensitivity of reporting. In 2013, an increase in the IPD incidence was observed. This finding requires further observation and a detailed vaccine impact analysis is needed to assess the current immunization strategy.

• MeSH
• Biostatistics MeSH
• Epidemiological Monitoring MeSH
• Mass Vaccination statistics & numerical data   MeSH
• Incidence MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Immunization Programs statistics & numerical data   MeSH
• Immunization Schedule MeSH
• Pneumococcal Infections epidemiology   prevention & control   MeSH
• Pneumococcal Vaccines administration & dosage   MeSH
• National Health Programs statistics & numerical data   MeSH
• Vaccines, Conjugate administration & dosage   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH

Očkovací kalendáře jednotlivých států Evropy jsou velmi rozdílné. Největší variabilita se projevuje ve věkových indikacích, typech očkování a počtu dávek, včetně rozdílných intervalů aplikace. V praxi to znamená, že 30 evropských států má 30 rozdílných očkovacích kalendářů. Cíle očkování evropských zemí jsou i přes rozdílnost stejné. Kontrola a eliminace infekčních onemocnění pomocí účinné a bezpečné vakcinace osob všech věkových kategorií. V důsledku globalizace Evropy existuje řada argumentů pro případné sjednocení doporučení a tvorbu jednotného očkovacího kalendáře. Stejně tak jsou známé skutečnosti a argumenty, které tomu zase brání. Největší shodu v kalendářích lze nalézt v očkování proti difterii, tetanu a pertusi. V článku jsou popsány rozdílnosti kalendářů jednotlivých zemí, včetně srovnání se situací v České republice. Rozdílný je také přístup k povinnosti či dobrovolnosti očkování. Pouze 10 z uvedených evropských zemí má zákonem ustanovenou povinnost očkování. Významnějším cílem evropské vakcinace, než je sjednocení očkovacích kalendářů, by mělo být sjednocení postupů, jak zvýšit zájem o očkování, a zlepšení monitorování proočkovanosti a bezpečnosti očkování.

Vaccination schedules vary widely among the individual European countries. The highest diversity is found in ages at which vaccination is indicated, types of vaccinations and numbers of doses, including different application intervals. Which in practice means that 30 European countries have 30 different vaccination schedules. However, the goals of vaccination are the same despite this diversity, namely controlling and eliminating infectious diseases, using effective and safe vaccinations in all age groups. There are many of arguments for potential standardisation of guidelines and for uniform vaccination schedule development in consequence of European integration, though on the other hand, many counter-arguments and factors obstructing such unification exist as well. Much common ground can be found can be find in cases of vaccination schedules for diphtheria, tetanus and pertussis. The article describes differences between the vaccination schedules in various European countries, including comparisons with situation in Czech Republic. The attitudes to the vaccinations being mandatory or voluntary differ between the individual countries as well. Only 10 from the listed European countries have mandatory vaccinations as a part of their legislature. Unifying the procedures aimed at increasing the interest in vaccination and improved monitoring of the vaccination rates and safety of vaccination should be regarded as more pressing goals than uniform vaccination schedules.

• Keywords
• povinné očkování,
• MeSH
• Child MeSH
• European Union * MeSH
• Mass Vaccination * methods   utilization   MeSH
• Internationality MeSH
• Infant MeSH
• Humans MeSH
• International Cooperation MeSH
• Infant, Newborn MeSH
• Immunization Programs * economics   organization & administration   statistics & numerical data   MeSH
• Immunization Schedule * MeSH
• Child, Preschool MeSH
• Practice Guidelines as Topic MeSH
• Vaccines administration & dosage   MeSH
• Health Policy MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH
• Geographicals
• Czech Republic MeSH

• MeSH
• Global Health * MeSH
• Humans MeSH
• Immunization Programs * methods   statistics & numerical data   trends   MeSH
• Poliomyelitis prevention & control   MeSH
• Cancer Vaccines MeSH
• Developing Countries MeSH
• World Health Organization MeSH
• Diphtheria-Tetanus-Pertussis Vaccine * therapeutic use   MeSH
• Check Tag
• Humans MeSH