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    • Besides the usual pro- and anti-vaccine lobby arguments, there are more issues here. The included strains have to be decided on by the WHO long before the season starts. And like in this season (in The Netherlands and the UK at least), sometimes another strain proves to be involved (Influenza B/Yagamata strain) and causes a lot of confirmed influenza cases. Next to that – and perhaps even the first concern – is that the effectiveness of the flu vaccine is not like that of e.g. the polio vaccine. And last but not least, the vaccination coverage has to be high to achieve the so-called herd immunity. In the 2016-2017 season vaccine effectiveness was around 38% in the Netherlands.
      Pneumococcal pneumonia is the most feared complication of the flu, especially in elderly people. To prevent this pneumonia, several pneumococcal vaccines do exist. Unfortunately, also their effectiveness is pretty low for these elderly.
      I dare to challenge here the cost-effectiveness and even the effectiveness of these influenza and pneumonia vaccines, especially when it comes to preventing death in the elderly people. The results are not strengthening trust in vaccination in general.
      And I sincerely hope that a really effective universal flu vaccine will be available soon!