The IFPMA IVS seasonal influenza vaccine dose distribution survey 2022-2023: evidence of the need for committed national investment in and uptake of seasonal influenza vaccination.

Seasonal influenza vaccines have the potential to prevent significant morbidity and mortality and the World Health Organization recommends that all countries consider implementing seasonal influenza immunization programmes. These provide invaluable supports to pandemic response, whether through the utilization of influenza epidemiological surveillance systems such as the WHO Global Influenza Surveillance and Response System (GISRS) or RespiMart, by imparting countries with ability to scale up vaccination in response to pandemics, and by contributing to the global production capacity for vaccines. During the COVID-19 pandemic, countries with higher influenza vaccination coverage also achieved higher COVID-19 vaccination coverage. But vaccine hesitancy and complacency are preventing optimal benefits from seasonal influenza vaccination. In 2008, the International Federation of Pharmaceutical Manufacturers and Associations' (IFPMA) Influenza Vaccine Supply International Task Force (IVS) developed a survey method to estimate vaccination coverage rates. The present survey, for 2022 and 2023, highlights that the vast improvements in seasonal influenza vaccination coverage rates achieved during 2020 and 2021 are regrettably not being sustained. Twenty-seven fewer countries in 2022 and 29 fewer countries in 2023 distributed any doses of seasonal influenza than in the peak year for number of countries, 2011. In 2023 there were 17 % fewer vaccine doses distributed globally than in the peak year, 2020. Only 33 of 195 countries achieved the hurdle rate in 2023, defined as number of doses distributed to ≥15.9 % of the population. Governments can strengthen performance of their seasonal influenza vaccination programs with a few key actions. Because immunization returns up to 19 times the cost in societal value, it is critical for governments to identify and implement appropriate countermeasures to vaccine hesitancy and complacency including vaccine advocacy, communications, and communication training for Healthcare Workers. Governments' challenge is to sustain resolve beyond the public health emergency of COVID-19.