On the contrary, a notable trend towards reduction of SIVU has been observed in several countries among different at-risk groups: in the Netherlands, between 2008/09 and 2013/14, for the at-risk groups overall [ 6 ]; in Spain between 2008/09 and 2011/12 among those younger than 60 years with a chronic disease [ 7 ]; in France, between 2009/10 and 2011/12, in those aged ≥ 65 years and in some of the younger at-risk groups, such as those with diabetes [ 8 , 9 ].
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Trends in seasonal influenza vaccine coverage of target groups in France, 2006/07 to 2015/16: Impact of recommendations and 2009 influenza A(H1N1) pandemic.
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