Four sudden deaths in persons aged 52 to 75 years with underlying cardiac conditions were reported in Israel over a period of 5 days. All had received influenza vaccine from the same lot in the days preceding death, raising concern about the safety of the vaccine. The Israeli Ministry of Health suspended temporarily their annual vaccination programme pending an investigation. The results of this investigation have ruled out any causal link with the influenza vaccine and the Israeli Ministry of Health resumed vaccination on 24 October.

The four men who died belonged to a group at high risk of natural sudden death by their age and underlying conditions. Such clustering of deaths in time and space is dramatic but not unexpected. In ECDC’s view there is no reason not to continue with the annual immunisation programmes in EU countries. ECDC will, however, continue to monitor the situation and is in contact with its Israeli counterparts.