Influenza vaccination in Austria from 1982 to 2023 - decades of consistent ignorance and refusal

Ursula Kunze^*Richard FelsingerErnest Groman

• Medical University of Vienna, Vienna, Austria

Influenza still tops the list of vaccine-preventable diseases and deaths in Austria. For more than four decades, Austria has grappled with persistently low rates of influenza vaccination, despite the clear availability of vaccines and recommendations from health authorities. Understanding the historical context and the societal attitudes that have shaped these trends is essential for informing future public health strategies and policy interventions. An average epidemic results in approximately 350,000–400,000 cases and 1,300 deaths annually. Despite this, vaccination rates in Austria are still alarmingly low, with coverage slightly above 10%, making it one of the lowest worldwide. Three earlier publications have reported the Austrian influenza vaccine use over several time periods between 1982 and 2015. This study extends these findings, analysing data from eight additional influenza seasons (2016/17 to 2023/24), offering four decades insights. Vaccine use data, presented as vaccine dose distributions per 1000 population and vaccination rate percentages, from international studies and from the Austrian market only, were used. Austria has consistently ranked among the countries with the lowest vaccine distribution rates; the number peaked in 2006 at 142 doses per 1000. Since 2007, there has been a steady decline to 62 doses per 1000 in the 2015/16 season, like levels observed in the mid-1990s. In the following years, a slight increase was observed to 85 doses per 1000 in the 2019/20 season. During the first year of the COVID-19 pandemic, the number of doses distributed more than doubled to 221 doses per 1000, before falling again in subsequent seasons.