Gender issues in chronic diseases and influenza vaccines

People with already existing conditions, such as cardiovascular diseases, diabetes, and pulmonary/respiratory disease, are at greater risk from influenza (Logue et al., 2011). Women are more likely to have diabetes in their lifetime than men, and studies in the US show that women, particularly those in lower socioeconomic groups, receive less adequate diabetes care than men from the same socioeconomic group (WHO, 2010). Also, these women face more variability of the number of services received in addition to factors such as childcare and availability of transport, resulting in an unequal outcome between men and women.

Individuals with underlying medical conditions, for example cardiovascular problems, asthma, obesity, chronic lung disease, kidney disease, liver disease, immunosuppressant diseases, cancer, HIV, and diabetes, are one of the main risk groups of contracting influenza (WHO, 2012). However, these groups are not necessarily all being vaccinated. The individual person may be managing their health condition successfully, and despite coping effectively with a condition, do not view themselves as being part of an at-risk group for influenza (International Longevity Centre UK, 2011). Identification of the appropriate targets for influenza vaccination in these groups is often challenging, and require considerable effort and cost (WHO, 2012). In Europe, vaccination compliance rates are relatively low among chronically ill persons compared to the U.S. (Tell Me, 2012).

Healthy adults may also need vaccination against influenza over their life trajectory without having an underlying medical condition. While influenza is most virulent among the very young and among older persons, biological and hormonal changes across the life span can affect the exposure to influenza and the severity of the infection. For example, women experience a five to 10-year period of changes in hormone patters caused by menopause (WHO, 2010), which may make them more vulnerable to influenza infection.

The International Longevity Centre UK argue that vaccinations along the life course trajectory should be considered a normal part of adult life and not just childhood, and that emphasis on vaccination should include those over 50 years of age (2011).  Lowering the age limit for vaccination may be effective in increasing vaccine uptake (ECDC, 2013).  A Spanish study found that among those under 65 years of age with chronic conditions, influenza vaccination figures are very low at approximately 30% (Jiménez-García et al., 2010); changing the vaccination age limit to 50 and over may help increase this number.


European Centre for Disease Prevention and Control (2013) Review of scientific literature on drivers and barriers of seasonal influenza vaccination coverage in the EU/EEA, Stockholm: ECDC.
International Longevity Centre UK (2011) Life Course Immunisation Improving adult immunisation to support healthy ageing, London: International Longevity Centre - UK.
Jiménez-García, R., Hernández-Barrera, V., Lopez de Andres, A., Jimenez-Trujillo, I., Esteban-Hernández, J., and Carrasco-Garrido, P. (2010) ‘Gender influence in influenza vaccine uptake in Spain: Time trends analysis (1995-2006)’, Vaccine, 28(38), 6169-6175.
Logue, E., Dudley, P., Imhoff, T., Smucker, W., Stapin, J., DiSabato, J., and Schueller, C. (2011) ‘An opt-out influenza vaccination policy improves immunization rates in primary care’, Journal of Health Care for the Poor and Underserved, 22(1), 232-242.
Tell Me (Transparent communication in Epidemics: Learning Lessons from experience, delivering effective Messages, providing Evidence) (2012) D1.7 Population behaviour in Epidemics Summary Report, Brussels: European Commission.
World Health Organisation (2010) Sex, gender and influenza, Geneva: World Health Organisation.
World Health Organisation (2012) Vaccines against influenza WHO Position Paper, Geneva: World Health Organisation.

MMLAP and other EU Projects

Health system analysis to support capacity development in response to the threat of pandemic influenza in Asia
Making society an active participant in water adaptation to global change
Public Participation in Developing a Common Framework for Assessment and Management of Sustainable Innovation
Engaging all of Europe in shaping a desirable and sustainable future
Expect the unexpected and know how to respond
Driving innovation in crisis management for European resilience
Effective communication in outbreak management: development of an evidence-based tool for Europe
Solutions to improve CBRNe resilience
Network for Communicable Disease Control in Southern Europe and Mediterranean Countries
Developing the framework for an epidemic forecast infrastructure
Strengthening of the national surveillance system for communicable diseases
Surveillance of vaccine preventable hepatitis
European monitoring of excess mortality for public health action
European network for highly infectious disease
Dedicated surveillance network for surveillance and control of vaccine preventable diseases in the EU
Modelling the spread of pandemic influenza and strategies for its containment and mitigation
Cost-effectiveness assessment of european influenza human pandemic alert and response strategies
Bridging the gap between science, stakeholders and policy makers
Promotion of immunization for health professionals in Europe
Towards inclusive research programming for sustainable food innovations
Addressing chronic diseases and healthy ageing across the life cycle
Medical ecosystem – personalized event-based surveillance
Studying the many and varied economic, social, legal and ethical aspects of the recent developments on the Internet, and their consequences for the individual and society at large
Get involved in the responsible marine research and innovation
Knowledge-based policy-making on issues involving science, technology and innovation, mainly based upon the practices in Parliamentary Technology Assessment
Assessment of the current pandemic preparedness and response tools, systems and practice at national, EU and global level in priority areas
Analysis of innovative public engagement tools and instruments for dynamic governance in the field of Science in Society
Public Engagement with Research And Research Engagement with Society
Computing Veracity – the Fourth Challenge of Big Data
Providing infrastructure, co-ordination and integration of existing clinical research networks on epidemics and pandemics
Promote vaccinations among migrant population in Europe
Creating mechanisms for effectively tackling the scientific and technology related challenges faced by society
Improve the quality of indoor air, keeping it free from radon
Improving respect of ethics principles and laws in research and innovation, in line with the evolution of technologies and societal concerns
Investigating how cities in the West securitise against global pandemics
Creating a structured dialogue and mutual learning with citizens and urban actors by setting up National Networks in 10 countries across Europe
Identifying how children can be change agents in the Science and Society relationship
Establishing an open dialogue between stakeholders concerning synthetic biology’s potential benefits and risks
Transparent communication in Epidemics: Learning Lessons from experience, delivering effective Messages, providing Evidence