Gov’t shifts focus to flu prevention beyond managing vaccination rates

The Korean Senior Citizens Association and political parties call for adoption of high-immunogenicity vaccines

Consensus grows on shifting focus to prevention effectiveness…budget review remains a challenge

As South Korea entered a super-aged society last year, with the population aged 65 and over surpassing 10 million, calls are growing for a shift in the direction of influenza vaccination policy for older adults.

Recent calls from the Korean Senior Citizens Association (KSCA) and political parties for the adoption of high-immunogenicity influenza vaccines for older adults have sparked interest in whether the National Immunization Program (NIP) can evolve from a policy focused primarily on vaccination coverage to one centered on effective prevention.

According to industry sources on the 4th, the KSCA mentioned the need to transition toward a tailored influenza vaccination strategy for older adults for a policy recommendation this year, in a proposal.

The association noted that while free influenza vaccination is currently provided to older adults aged 65 and over through the National Immunization Program, the vaccine's effectiveness may be relatively low due to age-related decline in immune function. Accordingly, it suggested the need to consider the phased introduction of vaccines with higher preventive efficacy to ensure the practical prevention of diseases and secure the health rights of seniors.

The issue has also gained attention in the political arena.

Both the Democratic Party of Korea and the People Power Party recently referenced the introduction or gradual expansion of high-immunogenicity influenza vaccines for older adults in their policy platforms. Although their implementation approaches differ, both parties share the view that vaccination policy for older adults should move beyond vaccination rates and place greater emphasis on actual preventive effectiveness.

Disease burden remains high despite strong vaccination coverage

Influenza vaccination coverage among Koreans aged 65 years and older remains above 80%. Nevertheless, influenza-related hospitalizations and deaths continue to be concentrated in this age group, and the disease burden has increased alongside larger seasonal outbreaks.

Experts attribute this phenomenon to immunosenescence, the gradual deterioration of immune system function associated with aging. As immune responses generated after vaccination weaken with age, the real-world protective effect of vaccines may also decline.

In a study conducted by eight university hospitals in Korea, the effectiveness of standard-dose influenza vaccines among adults aged 65 years and older was estimated to be around 14%.

As a result, experts argue that vaccination coverage alone is insufficient to reduce disease burden in older adults and that vaccination strategies should also consider reductions in hospitalization and severe disease.

Major countries expand strategies focused on the prevention effect.

Many countries have already expanded vaccination strategies tailored to age and risk profiles.

The US Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) has recommended high-immunogenicity vaccines—including high-dose and adjuvanted influenza vaccines—for adults aged 65 years and older since the 2022–2023 influenza season.

Germany's Standing Committee on Vaccination (STIKO) recommends high-dose influenza vaccines for adults aged 60 years and older. Taiwan introduced high-immunogenicity vaccines this year for elderly residents of long-term care facilities, while Japan is expanding the use of such vaccines among adults aged 75 years and older.

The policies of these countries focus not only on managing the simple vaccination rate but also on meaningful health outcomes such as reduced hospitalization rates, prevention of severe illness, and alleviation of healthcare burdens.

However, further discussion will be needed before high-immunogenicity vaccines can be incorporated into Korea's National Immunization Program. Issues such as financial burden, cost-effectiveness assessments, and prioritization of target populations remain to be addressed.

Whether the policy is ultimately adopted will depend on future discussions by the Korea Disease Control and Prevention Agency (KDCA) and the Korea Expert Committee on Immunization Practices (KECIP). Nevertheless, as Korea continues to age rapidly and the infectious disease burden among older adults increases, debate over shifting vaccination policy from a vaccination rate-focused approach to one centered on the preventive effect and progression to severe disease is expected to continue.