This “hurdle” rate of 159 doses per 1000 population was previously defined as the number of doses required to vaccinate those aged 65 years or older in more developed nations

[8], and was again utilized to enable comparisons with previous reports. Countries with the greatest proportional increases in per capita dose distribution between 2008 and 2011 were compared to those countries with the greatest proportional decreases for the same period. Wnt inhibitor This excludes 2009 and 2010 data due to the H1N1 influenza pandemic vaccine distribution. To compare a similar number of countries with increases and decreases in dose distribution, 18 countries with the greatest rate of change were compared. Countries with the greatest proportional increase were selected according Autophagy Compound Library to the hurdle rate: 9 countries below and 9 countries above the hurdle rate in 2008. Countries with the greatest proportional decrease were selected in the same way. The total numbers of IFPMA IVS doses of seasonal influenza vaccine distributed has risen from approximately 262 million in 2004 to about 489 million in 2011, an 87% increase. The breakdown in annual change is shown by WHO region in Fig. 1. The greatest rate of growth was seen in SEARO but the numbers

of doses distributed remain small for the region: 8.2 million in 2011. The lowest number of doses in 2011 was distributed to AFRO (approximately 3.8 million), and the greatest number was distributed in AMRO (255.6 million doses). EURO had the lowest rate of growth of all regions with a 29% decrease between 2008 (which was a peak year at approximately 144.2 million doses distributed) and 2011 (102.8 million doses distributed), for an overall growth of 14% between 2004 and 2011. Accounting for variations in country size, the data were rendered comparable by calculating the ratio of IFPMA IVS doses distributed per 1000 population,

as shown in, for 2008 and 2011. Data for AFRO, SEARO and EMRO are shown combined because they only account for 3.7% of the more than 489 million doses distributed in 2011. AFRO accounts for less than 1% of doses distributed Isotretinoin (about 0.77% in 2011). In AMRO (Fig. 2), 21 out of 33 countries (64%) in the region increased the per capita dose distribution between 2008 and 2011 and was significantly different in 2011 (p = 0.008). Doses distributed per 1000 population ranged from a high in the US of 476.6 in 2011 to a low of 0.69 in Haiti. In EURO (Fig. 3), the highest per capita distribution in 2011 was observed in the UK and the Netherlands at 269.5 doses per 1000 population each. However, a significant number of countries have considerably reduced utilization rates since 2008. This change was significant (p = 0.002) between 2008 and 2011.