Expert: Life-course immunisation will save costs and lives

The adoption of a life-course immunisation approach in the EU will have significant multi-level effects, ranging from a healthier population to savings in healthcare budgets, Dr Daphné Holt told EURACTIV.com.

Dr Daphné Holt is the chair of the Coalition for Life-Course Immunisation. She spoke to EURACTIV’s Sarantis Michalopoulos on the sidelines of the European Health Forum in Gastein, Austria.

INTERVIEW HIGHLIGHTS

• A life-course immunisation approach will prolong and enhance the quality of life
• For society and governments, there are significant savings from reducing the burden on health and social systems
• The EU can be a focal point for liaising with vaccine developers, manufacturers and distributors
• The European policy momentum is moving in the right direction

What are the main challenges you are faced with when it comes to a life-course approach on immunisation?

Encouraging society to embrace the idea that vaccination is not just a one-off for children but that is needed at all ages and stages of life, particularly when other issues make infectious diseases more likely and/or more dangerous.

Education is key to this so that people make informed and appropriate decisions about which immunisations and when right from the start. With better information, people will be aware of situation-specific as well as age-specific immunisation.

Healthcare professionals are the most trusted sources of advice, so ensuring they have access to high quality, digestible information and training is critically important.

Helping policymakers to make the same leap to fully espouse the benefits of the life-course approach, leadership is needed from the top but also determined advocacy from the population.

Making behavioural change sustainable is necessary so that boosting and repeating immunisation becomes part of life’s routine. Quality, consistency and transparency of information is paramount in a world in which there is a climate of ‘expert denial’ and anti-vaccine noise. In this respect, authorities and pro-health groups must engage fully with social media.

What are the benefits of life-course immunisation? Could it potentially lead to savings for the healthcare budgets?

If each individual adopted an LCI approach it could boost their lifetime immunity to infectious disease, leading to a healthier (ageing) population.

Additionally, immunisation against common diseases will protect against co-morbidity effects with other conditions and diseases. This will prolong and enhance the quality of life.

Widespread uptake of immunisation will lead to immunity across the community even protecting those unable or unwilling to be vaccinated as well as those who arrive without a history of immunisation such as refugees.

For society and governments, there are also significant savings from reducing the burden on health and social systems (vaccination may save more than 10x its original cost). Additionally, the impact of antimicrobial resistance is causing higher healthcare costs as well as the growth in difficult to treat diseases and conditions.

Immunisation has been shown to be effective in reducing the impact of antimicrobial resistance and hence healthcare system costs.

What could be done at the EU level in this direction, considering that immunisation is a national competence.

Immunisation is a national competence and so, each nation must make its own leadership and implementation choices. However, the EU has a role to play.

The EU can be a focal point for liaison with vaccine developers, manufacturers and distributors; helping to ensure competitive pricing, efficient and effective purchasing timetables in order to guarantee sufficient supply and even create stockpiles if members want it.

It can encourage the sharing of best practices in production and implementation by member states of National plans to increase coverage so that WHO European action plan meets targets by 2020. The EU can also make funds available for research.

There is an EU Council Recommendation on strengthened cooperation against vaccine-preventable diseases. Where does it currently stand?

We are pleased to see the European policy momentum moving in the right direction toward a life-course approach, starting with support from the European parliament with the resolution on vaccine hesitancy which calls on the member states, given the usefulness of vaccination as a preventive tool, to ensure that vaccine coverage is extended beyond early childhood, and that all population groups can be included in a lifelong vaccination approach;

This call seemed to have resonated with the European commissions who included the life-course immunisation heavily in its Council Recommendation proposal presented last summer. Notably, the proposal calls on member states to develop and implement their own national vaccination plans by 2020, following a life-course approach to vaccination.

This comprises routine checks and regular opportunities to vaccinate across all stages of life including at schools, workplaces and care facilities but also offers provisions for sustainable funding.

The role of healthcare professionals is central to the adoption of vaccination programmes and there is a clear call from all stakeholders on the need to strengthen vaccination training in medical curricula and continuous medical training for all health workers.

It is our understanding that discussions have progressed very quickly since the Commission presented the recommendation and that it will be formally adopted by ministers in December.

We also understand that the references to life-course immunisation from the original Commission proposal I just mentioned were not contentious, and therefore will be in the final text.

How could EU member states be convinced that a holistic approach is needed? Why do you think they have not seen that yet?

The emphasis on the cross-border nature of infectious diseases, shortage of supply and growing anti-vax sentiment means there is common ground within member states for action at an EU level even though health and vaccination remains a country-specific competence.

A holistic approach can be fostered by the involvement of public advocacy at the national and European level and includes cooperation across borders. Healthcare professionals using a multi-disciplinary approach have a large role to play as vaccine advocates both at the public and policy-making level, because once a groundswell of public opinion is built up, the effect will be seen on the political stage.