Copenhagen, 24 April 2026
The WHO European Region has made real progress on influenza vaccination over the past 15 years. Since 2008/2009, the number of doses distributed across the Region has doubled, and by 2021/2022 every Member State had established a national influenza vaccination programme – making it the first of WHO’s six global regions to achieve this. Yet a new study published in “The Lancet Regional Health – Europe” to coincide with European Immunization Week 2026, shows how uneven that progress remains and how far the Region still has to go.
The analysis conducted by WHO/Europe tracked influenza vaccination programmes across all 54 countries and areas of the Region over 15 seasons from 2008/2009 to 2022/2023. It is the most comprehensive picture of influenza vaccination in the Region since the COVID-19 pandemic.
In 2022/2023, high-income countries in the European Region distributed an average of 139.9 doses per 1000 people. In lower-middle-income countries, that figure was 14.6. Vaccination coverage among older adults – who account for 70% of all influenza-related deaths globally – stood at 55% in high-income countries and just 5% in lower-middle-income ones.
Seasonal influenza kills up to 650 000 people worldwide each year and causes up to 5 million severe cases.
Missed target, missed opportunity
In 2003 the World Health Assembly set a target of vaccinating 75% of older adults against influenza. Two decades later, in 2022/2023, only 4 of the 54 countries and areas in the WHO European Region met it, namely Belarus, Denmark, Ireland and the United Kingdom.
“These numbers tell a clear story about who we are protecting and who we are leaving behind, and sadly it’s a tale of inequality,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “A tenfold gap in dose availability within a single region should concern every health minister in the European Region. But the good news is that this is solvable. We know that making vaccines free removes one of the biggest barriers to uptake. We know that confronting misinformation and building trust in communities drives demand. And we know that countries do not have to figure this out alone – closing the gap is exactly what WHO/Europe is here to help with.”
Gaps in data
Yet monitoring gaps remain a serious problem. Every country in the Region now recommends influenza vaccination for health workers, yet fewer than two thirds report whether health workers are actually being vaccinated. Furthermore, fewer than 1 in 3 countries report vaccination coverage data for people with chronic conditions like diabetes, heart disease and cancer – groups that are particularly vulnerable to severe influenza.
“There are promising signs of what is possible,” continued Dr Kluge. “Flu vaccination among older adults in the European Region rose during the first COVID-19 winter in 2020/2021 and appears to have held in subsequent seasons – a pattern that contrasts with declines reported elsewhere in the world.”
Some countries are building programmes from the ground up. In 2025, Tajikistan procured influenza vaccine doses for the first time, directing them to health workers most exposed to the virus. The country plans to double its vaccine orders by 2030, with the aim of protecting both its health workforce and its capacity to respond to future pandemics.
“Every country in this Region now has a flu vaccination programme. The question is no longer whether the infrastructure exists but how it can be put to better use to reach the people who need it most,” said Pernille Jorgensen, lead author and WHO/Europe Technical Officer for Pandemic Respiratory Diseases. “This comprehensive study shows that accelerated global efforts are needed to improve access to affordable and effective influenza vaccines, alongside national initiatives to identify and address barriers to vaccination.”