Adult immunisation key in shift towards preventative health

European populations are growing older, increasing the burden on already struggling health systems, but one way of reducing the burden is through adult immunisation programmes to combat vaccine-preventable diseases.

At a recent EURACTIV event on public health and disease prevention, Yan Sergerie, director of global medical affairs at pharmaceutical company GSK, explained that the vast majority of the costs associated with treating vaccine-preventable diseases result from people who are not vaccinated.

“From an overall value perspective, vaccination has to be seen as a way to decrease the number of clinic visits, physician treatments, hospitalisations, prescriptions, and eventually mortality,” said Sergerie.

According to data from the Organisation for Economic Co-operation and Development (OECD) collected from 26 countries, more than one-third of people aged 16 and over live with a longstanding illness or health problem.

With populations growing older, the number of chronic diseases rises, which leads to more complications from vaccine-preventable diseases.

Many countries have immunisation programmes for children, but many vaccine-preventable diseases also occur in adults, such as influenza, hepatitis, human papillomavirus (HPV), tetanus, tuberculosis and many more.

“The burden of disease for most infectious diseases is U-shaped,” said Joe Schmitt, board member of the Coalition for Life Course Immunisation (CLCI), referring to the fact that high disease severity happens either early or late in life.

According to the expert, vaccination remains the most effective way to ‘produce health’ and spend less. “In the decade of austerity to come, we can only make the best use of our resources if we give priority to vaccines and vaccination,” Schmitt added.

There are several barriers to achieving successful adult immunisation programmes, yet a key factor is for countries to have the right policies.

“It’s important to consider that you depend on the national immunisation programmes. So you get the vaccines recommended by your health care authorities,” said Sibilia Quilici, executive director at Vaccines Europe.

Quilici argued that the adult vaccines should be embedded into the national immunisation programmes, so they reflect a life course strategy, mentioning that it is possible to prevent up to 20 infectious diseases across the whole lifespan from childhood to older adults.

“Today these represent just less than 0.5% of the healthcare budget (…). So very, very little budget to prevent so many infectious diseases that can lead to significant comorbidities and costs to the society,” said Quilici.

National immunisation routines 'more critical than ever' in wake of COVID-19 outbreak

The recent COVID-19 outbreak has demonstrated that we must not let down our guard on  routine immunisations, Dr Hans Kluge, World Health Organisation (WHO) regional director for Europe, stressed in a speech marking European Immunisation Week 2020.

How to get there

In order to get strong adult immunisation programmes in place in European countries, there are several barriers to overcome.

According to Pierre van Damme, professor of vaccinology and infectious diseases at the University of Antwerp, we, first of all, need awareness amongst adults of all ages and occupations about immunisation and prevention.

“This is really a challenge to have the whole group well aware about the different aspects of immunisation, infectious disease and prevention,” van Damme said.

He highlighted the COVID-19 booster immunisation programmes as an example of the challenge, while it has been targeting risk groups and the above-50 population.

“In some countries, a lot of this 50-plus population did not consider themselves as being at [an increased] risk,” he said, making a case for proper communication surrounding immunisation.

Van Damme also mentioned that pre-COVID, it was rare for the healthcare sector in many countries to reach out to adults.

“So not waiting for a complaint or for any symptom, but in a proactive way trying to reach this population and offer a preventive measure,” he said, advocating also for more education of medical students, midwives, nurses and more on the topic of adult immunisation.

Investments into primary care is another key point, argued Tomislav Sokol, MEP for the European People’s Party (EPP).

“We have to provide incentives for health care providers to specialise in primary care,” Sokol said.

“(We) have to more clearly define what the role for primary care in terms of public health protection, in general, when we speak of immunisation,” he added.

With other issues such as vaccine hesitancy also rising, there are plenty of issues to tackle.  EU member states have kept full competencies on health policy, but there is, however, a role for the EU to play as well.

“What the European Union can do is to support national policies through either funding, sharing best practices or providing administrative and other assistance [for member states],” said Sokol.

Health expert: Routine immunisation should not be put on back-burner due to COVID

A real commitment from all stakeholders and policymakers is needed to support a catch-up immunisation campaign and overcome the difficulties routine vaccination programmes have experienced during the pandemic, according to a key vaccine stakeholder.

This article follows the EURACTIV-organised policy debate “Public health and disease prevention – What benefits for an adult immunisation policy in Europe?” supported by GSK

[Edited by Gerardo Fortuna/Alice Taylor]

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