Vaccine European New Vaccine European New Integrated Collaboration EffortIntegrated Collaboration Effort

V.E.N.I.C.EV.E.N.I.C.E

Stefania SalmasoItalian National Centre of Epidemiology, Surveillance and Health Promotion

Istituto Superiore di SanitàRome-Italy

DGSANCO project

Vaccination in EUVaccination in EU

Total population of approx 459 millions in Total population of approx 459 millions in 25 countries25 countries

Approx 75 millions up to 14 years of ageApprox 75 millions up to 14 years of age Approx 75 millions aged more than 64 Approx 75 millions aged more than 64

yearsyears Approx 4.7 millions yearly EU birth cohortApprox 4.7 millions yearly EU birth cohort

RationaleRationale Currently many vertical projects addressing single diseases or Currently many vertical projects addressing single diseases or

infections, including some preventable by vaccination (e.g. infections, including some preventable by vaccination (e.g. Euvac-net, IBIS, EISS)Euvac-net, IBIS, EISS)

No project in the Public Health field is addressing vaccination No project in the Public Health field is addressing vaccination with an horizontal approach within a EU perspectivewith an horizontal approach within a EU perspective

Similarly at EU level there are many other activities on vaccine Similarly at EU level there are many other activities on vaccine evaluation (e.g. EMEA) that are not immediately available on evaluation (e.g. EMEA) that are not immediately available on the Public Health area. the Public Health area.

Take advantage of the already made experience and available Take advantage of the already made experience and available data, obtained in other concurrent networks and research data, obtained in other concurrent networks and research projects (e.g. DG Research funded Polymod)projects (e.g. DG Research funded Polymod)

Use of information technology developed for IRIDE project.Use of information technology developed for IRIDE project.

VACCINE

E U R O P E A N

E F F O R T

I N T E G R A T E D

COLLABORATION

Specific ObjectivesSpecific Objectives1.1. To create an EU vaccination network able to collect and collate information To create an EU vaccination network able to collect and collate information

on vaccination programs in each MS.on vaccination programs in each MS.

2.2. To create a resource able to provide advice and support to single member To create a resource able to provide advice and support to single member states by integrating available tools and knowledge on various vaccine-states by integrating available tools and knowledge on various vaccine-related issues . related issues .

3.3. To create a network able to provide support in the development of To create a network able to provide support in the development of preparedness strategies including immunisation programs.preparedness strategies including immunisation programs.

4.4. To define common indicators for monitoring, in a comparable way, the To define common indicators for monitoring, in a comparable way, the immunisation programs across MSs and as well their constituent regions. immunisation programs across MSs and as well their constituent regions.

5.5. To encourage a rational approach to vaccination policy decision-making To encourage a rational approach to vaccination policy decision-making processes by providing standardized tools. processes by providing standardized tools.

6.6. To provide MSs with the necessary information regarding safe vaccination To provide MSs with the necessary information regarding safe vaccination and support capacity building in areas dealing with contraindication and and support capacity building in areas dealing with contraindication and the management of Adverse Events following vaccination.the management of Adverse Events following vaccination.

Most relevant topicsMost relevant topics

the indicatorsthe indicators priority setting priority setting AE surveillance and managementAE surveillance and management

Working PackagesWorking Packages

WP 1: Coordination WP 1: Coordination (WP Leader: Stefania Salmaso) (WP Leader: Stefania Salmaso)

WP 2: Dissemination of resultsWP 2: Dissemination of results(WP Leader: Stefania Salmaso)(WP Leader: Stefania Salmaso)

WP 3: Indicators of immunisation programsWP 3: Indicators of immunisation programs(WP Leader: Darina O’Flanagan)(WP Leader: Darina O’Flanagan)

WP 4: Priority setting and decision-making processes WP 4: Priority setting and decision-making processes (WP Leader: Daniel Levy Bruhl)(WP Leader: Daniel Levy Bruhl)

WP 5: Capacity building in monitoring, prevention and WP 5: Capacity building in monitoring, prevention and management of post vaccination AE management of post vaccination AE (WP Leader: Antonio Ferro)(WP Leader: Antonio Ferro)

Development of tools and Development of tools and contentscontents

web-siteweb-site repository of documents of common repository of documents of common

interestinterest tool for confidential exchange of tool for confidential exchange of

messagemessage products related information for new products related information for new

vaccinesvaccines area for collecting country specific dataarea for collecting country specific data

Venice Public Web PortalVenice Public Web Portal

Web portal Web portal MenuMenu

http://venice.cineca.orghttp://venice.cineca.org

Project advancement (1)Project advancement (1) Two Annual WorkshopsTwo Annual Workshops Identification of National Gatekeepers and Identification of National Gatekeepers and

Contact PointsContact Points Website implemented Website implemented Five surveys among the member states Each Five surveys among the member states Each

survey preceded by a pilot undertaken by the survey preceded by a pilot undertaken by the Work Packages countries, and by other Work Packages countries, and by other randomly selected countries. randomly selected countries.

Project advancement (2)Project advancement (2) The first survey “Immunization Programs in The first survey “Immunization Programs in

Europe”. Results disseminated on the ECDC Europe”. Results disseminated on the ECDC biweekly newsletter. biweekly newsletter.

Two surveys, by WP4, on newly released Two surveys, by WP4, on newly released vaccines, against Rotavirus and Human vaccines, against Rotavirus and Human Papillomavirus. Papillomavirus.

Survey on “Vaccine Coverage” carried out by Survey on “Vaccine Coverage” carried out by WP3. WP3.

Survey on “Adverse Events Following Survey on “Adverse Events Following Immunization”, designed and launched by WP5, Immunization”, designed and launched by WP5, has gone the pilot phase.has gone the pilot phase.

““For better immunisation coverage, For better immunisation coverage, measure coverage better”measure coverage better”

• Papania M, Rodewald L. Lancet Editorial 2006 Papania M, Rodewald L. Lancet Editorial 2006 367367 965- 965-66

FormatFormat

• description schedulesdescription schedules• Methods of measuring coverageMethods of measuring coverage• Computerised Immunisation registriesComputerised Immunisation registries• Discussion US standards on CIRDiscussion US standards on CIR

FROM THE SURVEY ON IMMUNIZATION PROGRAMS: FROM THE SURVEY ON IMMUNIZATION PROGRAMS: Third dose of Diphtheria, Tetanus and Pertussis Third dose of Diphtheria, Tetanus and Pertussis

administered at 4,5,6, and 12 months of age.administered at 4,5,6, and 12 months of age.

4 months 5 months 6 months 12 months

Belgium Poland Austria1 Denmark

Bulgaria Slovenia Cyprus2 Finland

France Czech Republic Iceland

Germany Estonia Italy

Hungary Greece Norway

Luxembourg Ireland Slovakia

Netherlands Latvia Sweden

United Kingdom Lithuania

Portugal

Romania

Spain

FROM THE SURVEY ON IMMUNIZATION PROGRAMSFROM THE SURVEY ON IMMUNIZATION PROGRAMS Total Number of doses of Diphtheria and Tetanus by age 18 yearsTotal Number of doses of Diphtheria and Tetanus by age 18 years

4 5 6 7

Denmark Finland Austria Bulgaria

Sweden Iceland Belgium Estonia

Ireland Cyprus France

Italy Czech Rep Romania

Norway Germany

United Kingdom Greece

Hungary

Latvia

Lithuania

Luxembourg

Netherlands

Poland

Portugal

Slovakia

Slovenia

Spain

Lack of quality indicators for Lack of quality indicators for immunisation programmeimmunisation programme

Late start rates:Late start rates: % of infants who don’t % of infants who don’t have DTaP IPV Hib 1, MenC 1 by 3 have DTaP IPV Hib 1, MenC 1 by 3 months of agemonths of age

Drop –off ratesDrop –off rates:: % with DPT1 at 6 % with DPT1 at 6 months -% with DTaP3 at 12 monthsmonths -% with DTaP3 at 12 months

Up-to-dateUp-to-date: fully vaccinated for age at : fully vaccinated for age at benchmark ages of 12 months , 24 benchmark ages of 12 months , 24 monthsmonths

National vs subnational Immunization National vs subnational Immunization

ProgramsPrograms Subnational administrative areas in 17/27 Subnational administrative areas in 17/27 countriescountries

In 8 countries (BE,FR,GE, ES,IR,IT,UK,SW) In 8 countries (BE,FR,GE, ES,IR,IT,UK,SW) differences with the national IP in terms of differences with the national IP in terms of

Type of disease targetedType of disease targeted Age groupAge group PurchasePurchase

Public Health setting vs private Public Health setting vs private sectorsector

In the majority of the countries vaccinations are In the majority of the countries vaccinations are administered within national health servicesadministered within national health services

In 6 countries mainly within the private sectorIn 6 countries mainly within the private sector

Establish “channels” has always been a success of VENICE

Thanks

http://venice.cineca.orghttp://venice.cineca.org