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Available online 3 November 2025
Vaccination coverage against flu: advances, challenges and inequalities by autonomous communities in Spain (2019–2023)
Cobertura vacunal contra la gripe: avances, desafíos y desigualdades por comunidades autónomas en España (2019–2023)
F.M. Escandell Ricoa,
, L. Pérez Fernándezb
a Profesor de enfermería, Departamento de enfermería, Universidad de Alicante, Spain
b Coordinadora enfermería, Centro de Salud Almoradí, Departamento de Salud 21 SNS, Orihuela, 03300 Alicante, Spain
Received 25 March 2025. Accepted 11 July 2025
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Table 1. Age groups, autonomous communities, and coverage.
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Abstract
Objective

To evaluate the vaccination coverage against seasonal influenza in Spain between 2019 and 2023, analyzing trends by population groups, autonomous communities and factors associated with temporal and contextual variations.

Methods

Retrospective longitudinal study using data from the Vaccine Information System (SIVAMIN). Coverage was analyzed in the following groups: children (6–59 months), adults (60–64, 65–74, >74 years), pregnant women and health personnel. Coverage was calculated as the percentage of vaccinated patients with respect to the susceptible population and a descriptive and regression analysis was performed to evaluate temporal trends.

Results

Between 2019 and 2023, those over 74 years of age maintained high coverage (>73%), with slight decreases. In the 65–74 age group, coverage was good but uneven across regions. In adults aged 60–64 years and pregnant women, a post-pandemic decline was observed. Coverage in health professionals fell markedly (from 66% to 44%). In children aged 6–59 months, incorporated in 2023, coverage was 36%, with marked regional disparities.

Conclusions

Vaccination coverage shows persistent progress and challenges, with significant inequalities by autonomous communities. Those over 74 years of age and pregnant women have maintained relatively high rates, reflecting campaigns aimed at these vulnerable groups. The pandemic boosted occasional coverage, but the trend was not sustained. Sustainable strategies are required to improve equity and maintain confidence in vaccination, especially in key groups such as children, health care providers, and by autonomous communities with less access.

Keywords:
Influenza vaccines
Vaccination coverage
Inequities in health
Risk groups
Public health
Resumen
Objetivo

Evaluar la cobertura vacunal frente a la gripe estacional en España entre 2019 y 2023, analizando tendencias por grupos poblacionales, comunidades autónomas y factores asociados a variaciones temporales y contextuales.

Método

Estudio longitudinal retrospectivo utilizando datos del Sistema de Información de Vacunas (SIVAMIN). Se analizaron las coberturas en los grupos: niños (6–59 meses), adultos (60–64, 65–74, >74 años), embarazadas y personal sanitario. Las coberturas se calcularon con el porcentaje de vacunados respecto a la población susceptible y se realizó un análisis descriptivo y de regresión para evaluar tendencias temporales.

Resultados

Entre 2019 y 2023, los mayores de 74 años mantuvieron coberturas altas (>73%), con leves descensos. En el grupo de 65–74 años, las coberturas fueron buenas pero dispares entre regiones. En adultos de 60–64 años y embarazadas, se observó un descenso postpandemia. La cobertura en profesionales sanitarios cayó notablemente (del 66% al 44%). En niños de 6–59 meses, incorporados en 2023, la cobertura fue del 36%, con marcadas desigualdades regionales.

Conclusiones

La cobertura vacunal muestra avances y retos persistentes, con desigualdades por comunidades autónomas significativas. Los mayores de 74 años y las embarazadas han mantenido tasas relativamente altas, reflejo de campañas dirigidas a estos grupos vulnerables. La pandemia impulsó coberturas puntuales, pero la tendencia no se mantuvo. Se requieren estrategias sostenibles para mejorar la equidad y mantener la confianza en la vacunación, especialmente en grupos clave como niños, sanitarios y por comunidades autónomas con menor acceso.

Palabras clave:
Vacunas contra la influenza
Cobertura vacunal
Inequidades en salud
Grupos de riesgo
Salud pública
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