Lisbon, November 13 – EUVABECO held a scientific session at the European Public Health Conference, organised by the European Public Health Association (EUPHA). The session was co-organized by the University of Crete, Riga Stradins University, Sciensano, the European Public Health Association’s Infectious Disease Control (EUPHA-IDC) and Global Health (EUPHA-GH) Sections, and the European Commission’s Health and Digital Executive Agency (HaDEA).

Chaired by Georgios Margetidis, of the European Health and Digital Executive Agency (HaDEA) and Elena Petelos, of the University of Crete, and President of EUPHA’s Global Health Section, the event highlighted key developments in the project and set a clear vision for enhancing vaccination practices across the European Union.

The session kicked off with Christos Lionis, of the University of Crete, Coordinator of EUVABECO, who emphasized the need for ongoing innovation in vaccination strategies. Reflecting on the lessons learned during the COVID-19 pandemic, Professor Lionis stressed the importance of creating a supportive environment that enables effective vaccine deployment, a crucial factor in preparing for future health crises.

Next, François Kaag from Syadem, France, provided an in-depth look at EUVABECO’s implementation framework. He explained how the project was structured to deliver implementation plans for versatile tools that can support a wide variety of vaccination practices.

Following this, Matthieu Billuart of Sciensano, Belgium, introduced EUVABECO’s suite of innovative tools, designed to support vaccination practice across five key domains: medical, social, industrial, modelling, and digital. He described ongoing pilot projects in several EU countries testing the plans for the five solutions: a clinical decision support (CDS) system for healthcare providers, enhanced data linkage for targeted vaccination, a digital European vaccination card, an electronic patient information leaflet, and a disease forecasting tool.

Dace Zavadska, of Riga Stradins University, Latvia, emphasized the importance of engaging diverse stakeholders, including National Immunization Technical Advisory Groups (NITAGs). Given the varied vaccination policies and healthcare systems across EU Member States, Professor Zavadska highlighted the need for adaptable trusted strategies tailored to local contexts.

The session concluded with Sibilia Quilici of Vaccines Europe, who urged stakeholders to maintain active engagement as EUVABECO moves into the pilot implementation phase, stressing that ongoing collaboration is critical to adapting the project’s tools to diverse healthcare settings.

The meeting also allowed EUVABECO to connect with European Commission (EC) representatives to discuss progress and explore synergies with other EC health initiatives, setting the stage for coordinated efforts to enhance public health resilience across the European Union.

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Lisbon, 12 November – EUVABECO actively participated in the pre-conference workshop “Best practices in EU-wide projects contributing to achieving the objectives of EU Health policies,” organized by the European Health and Digital Executive Agency (HaDEA) and the Joint Action on increasing the capacity of National Focal Points (NFP4Health). The pre-conference focused on preventing non-communicable diseases (NCDs), including cancer, and improving vaccination strategies across Europe.

The event brought together policymakers, researchers, and stakeholders to exchange insights on the uptake, transferability, scalability, impact, and sustainability of best practices. EUVABECO presented alongside other projects and associations (Vax-Action, Overcoming obstacles to vaccination, Perch JA, ECL, and PreventNCD, EAAD best, JA Implemental, JACARDI, Care4Diabetes).

Professor Christos Lionis, EUVABECO’s Coordinator from the University of Crete (Greece), represented EUVABECO on the panel addressing vaccination reference practices. He detailed how EUVABECO is developing implementation plans for five innovative tools to strengthen vaccination programs and underscored their potential to enhance public health across the region.

EUVABECO is dedicated to advancing evidence-based interventions and fostering collaborations to improve health in the EU. The following day EUVABECO also hosted a scientific session at the European Public Health Conference.

The session was opened by [right to left] Marina Zanchi, Director of the European Health and Digital Executive Agency (HaDEA); Ana Pedroso, Secretary-General of the Portuguese Ministry of Health; Miguel costa Castano, the EU4Health National Focal Point (NFP) for Portugal; and Michele Cecchini, Head of Public Health at the OECD.

The pre-conference workshop, “Best Practices in EU-Wide Projects Contributing to Achieving the Objectives of EU Health Policies”, with Marina Zanchi, Director of the European Health and Digital Executive Agency (HaDEA) stressing the support of HaDEA to disease control.

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On 7-8 October, EUVABECO partners gathered at Linköping University, Sweden, to officially launch the pilot implementation phase of the project, marking a major milestone. This meeting followed months of dedicated collaboration to develop the draft implementation plans, which will be publicly available on our website by the end of October 2024.

Given the diverse public health landscapes across Europe, the flexibility of these plans is crucial. The meeting offered a valuable opportunity for tool experts and implementing partners to engage in detailed discussions, addressing challenges they’ve already faced and sharing strategies to overcome them. It also allowed the consortium to reflect on how we can improve collaboration, exploring ways to optimize teamwork and make the most of each partner’s expertise.

A highlight of the event was a keynote speech by Dr. Anders Tegnell, Sweden’s former state epidemiologist, who played a pivotal role in shaping the country’s response to COVID-19. Dr. Tegnell shared insights into Sweden’s unique approach, which notably avoided lockdowns, distinguishing it from many other European countries. He explained that, while vaccination was the cornerstone of Sweden’s success in controlling the pandemic, different contexts demand tailored solutions. This aligns with EUVABECO’s philosophy: instead of promoting a one-size-fits-all approach, we offer a flexible suite of voluntary tools to help countries strengthen their vaccination programs in ways that fit their specific needs and circumstances.

The meeting, with both in-person and online participants, was an excellent opportunity to reconnect, align our goals, and set a clear path forward for the next phase of the project. We are eager to move ahead with the pilot implementations and continue our mission of supporting vaccination programs across Europe.

Stay tuned for the public release of our implementation plans at the end of this month!

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Schematic representation of the epidemiological compartment model implemented by the University of Saarland. [2, 3].

During the COVID-19 pandemic, one of the biggest challenges was the uncertainty around how well different measures – such as vaccination campaigns and lockdowns – would work. Policymakers had to make tough decisions without knowing exactly what the outcomes would be, which sometimes led to less-than-ideal results. To improve decision-making, some countries turned to mathematical models to analyse data, gain insights into the virus’s spread, the severity of the disease, the potential impact of various interventions, and to predict outcomes.

Modelling and forecasting play a critical role in public health by providing a systematic, data-driven approach to understanding disease spread and how interventions can affect it. Accurate models help anticipate potential scenarios, enabling timely and informed decision-making. This bridges the gap between theoretical planning and practical implementation, offering a data-driven foundation for public health policy. Models help identify strategies most likely to succeed under varying conditions, making them vital for preventing health crises or reducing their impact.

In Germany, the University of Saarland developed a “compartmental model” to predict how COVID-19 would spread and affect the population. This type of epidemiological model categorises the population into three disease stages: susceptible (S), infected (I), and recovered (R). It tracks how people move between these groups over time. By adjusting factors like the rate of virus transmission and the effectiveness of measures such as social distancing or vaccination, the model can simulate different scenarios and forecast how the virus might behave.

The University of Saarland’s model used data from multiple sources, including a database covering about 10% of hospitalized patients in Germany. The results were shared with the public through an online dashboard that attracted up to 200,000 visits daily at its peak. The tool’s success led to its adoption in other countries, including Switzerland, Spain, Italy, France, Luxembourg, and the United States [1-3].

As part of the EUVABECO project, the University of Saarland is currently expanding the scope of its tool to work with any infectious disease. They are collaborating with partners in Greece, Luxembourg, Poland, and Portugal on pilot projects aimed at deploying a predictive model that incorporates data from infection and outcome studies, current infection rates of COVID-19 and other infections, including other respiratory diseases, as well as regional data on hospitalizations, Intensive Care Unit (ICU) admissions, and deaths. The model will also consider existing interventions, like vaccination campaigns, and specific local outbreak responses, including non-pharmaceutical interventions (NPIs).

Modelling tools like these provide important information that helps policymakers and healthcare providers make timely, informed decisions, allocate resources effectively, and implement life-saving interventions. These forecasts are vital for planning, allowing healthcare systems to prepare for future needs, such as ICU beds and specialized treatments. Additionally, these tools help educate the public on the importance of timely interventions and build trust in public health strategies.

The first draft of the implementation plans is currently in development and will be released to the public on the EUVABECO project website in October 2024, coinciding with the launch of the pilot projects. These plans will undergo rigorous testing and refinement during the pilot phase to ensure they provide comprehensive guidance – covering operational, technical, and legal aspects – for countries looking to establish their own modelling and forecasting tools. This will help countries to gain actionable insights during infectious disease outbreaks, strengthening their ability to respond to future public health emergencies.

References

[1] Nunes MC et al. Redefining pandemic preparedness: Multidisciplinary insights from the CERP modelling workshop in infectious diseases, workshop report. Infect Dis Model. 2024 Feb 23;9(2):501-518. doi: 10.1016/j.idm.2024.02.008. PMID: 38445252; PMCID: PMC10912817.

[2] Dings C et al. Model-Based Analysis of SARS-CoV-2 Infections, Hospitalization and Outcome in Germany, the Federal States and Districts. Viruses. 2022 Sep 24;14(10):2114. doi: 10.3390/v14102114. PMID: 36298669; PMCID: PMC9607468.

[3] Dings C et al. Effect of vaccinations and school restrictions on the spread of COVID-19 in different age groups in Germany. Infect Dis Model. 2024 Jul 24;9(4):1250-1264. doi: 10.1016/j.idm.2024.07.004. PMID: 39183948; PMCID: PMC11342094.

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Delivering vaccines with detailed information in the patient’s and health professional’s own language ensures that patients can make informed decisions and that health professionals can administer vaccines correctly. European Union (EU) law aims to protect patients by ensuring that all vaccine packaging components – immediate packaging (syringes, vials, and applicators for nasal or oral vaccines), outer packaging (boxes or cartons), and the Patient Information Leaflet (PIL) – include information in the official language(s) of the distribution country.

Traditionally, the PIL has been a paper leaflet, which can be challenging to distribute efficiently. Vaccines need to be stored in refrigerated conditions with limited space, meaning leaflets must be small and restricted to three languages. There are 24 official languages in the EU/European Economic Area (EEA), and some countries have up to three official languages. Because of this, and because many EU countries are small, vaccination packaging needs to be made in small, country-specific batches.

This process is not only inefficient but also prevents timely responses to crises such as vaccine shortages due to the need to either repackage the vaccine, or to gain authorisation from the National Competent Authority of the concerned Member State to distribute the vaccination with packaging written in a foreign language.

To improve this process, EUVABECO partner Vaccines Europe suggests using neutral, common EU packaging, and replacing paper leaflets with Electronic Patient Information Leaflets (ePIL) [1]. The ePIL provides the same crucial information as the PIL but through digital platforms and offers several benefits:

• Real-time updates, ensuring accurate information, unlike paper leaflets that can become outdated.
• Reduced production time and improved logistical efficiency by simplifying packaging.
• Easier and faster re-routing of vaccines.
• Optimized refrigeration and storage capacity by minimizing bulky packaging.
• Increased environmental sustainability by reducing paper use and energy consumption.

For those with limited digital access, ePILs can be printed by healthcare professionals or family members in the patient’s preferred language, ensuring everyone receives essential vaccine information.

With Vaccines Europe’s expertise, EUVABECO is planning pilot projects in Belgium, Germany, Greece, Latvia, and Portugal starting in October 2024. These pilots aim to develop and test implementation plans for ePILs and will follow existing EU laws, particularly Directive 2001/83/EC, which governs the labelling and packaging of medicinal products.

Want to know more?

For more information about EUVABECO, please contact us directly at communications@euvabeco.net.

[1] https://www.vaccineseurope.eu/wp-content/uploads/2022/09/VE-CommonPackaging_InfographicSHEET-V10_FINAL_UPDATE_WEB.pdf

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Photo caption: During the COVID-19 pandemic in Belgium, databases from various sources were linked at the individual level to accurately identify and vaccinate high-priority groups, as well as to monitor vaccination progress and effectiveness.
Photo credit: Sciensano, the National Public Health Institute of Belgium.

How is EUVABECO linking data to optimize vaccination campaigns?

As the COVID-19 pandemic intensified, finding effective vaccination strategies became critical. Successful vaccination campaigns rely on evidence-based approaches and up-to-date data. Collecting new data is time and resource-intensive, so to ease the burden on the healthcare system, Belgium decided to use existing datasets, sparing health workers from additional tasks.

In early 2021, Belgium took an innovative approach by linking databases from various sources at the individual level. Unlike most vaccination campaigns that link data at a coarser level, this approach enabled detailed analysis and personalized insights on exhaustive population data. This allowed Belgium to accurately identify and vaccinate high-priority groups and monitor vaccination progress and effectiveness more effectively.

Specifically, Belgium set up the LINK-VACC project. This project linked patient-level data from health registries, testing platforms, and other public and private institutions. It measured vaccine effectiveness against symptomatic infections and hospitalizations and tracked vaccination coverage across different demographic and socio-economic groups. This information is crucial for policymakers to monitor and adjust vaccination campaigns effectively in response to the evolving virus. The LINK-VACC project ensured all data handling was GDPR-compliant, with measures like pseudonymization and secure data storage.

Early in the pandemic, limited vaccine availability made it necessary to prioritize vaccinations for the most vulnerable. In Belgium, medical experts defined priority groups like healthcare workers and the elderly. Using data linkage, these groups were identified based on risk factors like age, health status, and occupation, and invited for vaccination. In addition, non-elderly adults with underlying health conditions, leading to an increased risk of a severe COVID-19 infection, were prioritized as well. Around 1.5 million out of 7 million persons aged 18-64 years were identified as high-priority within this category using data from insurance records, general practitioners, and other healthcare sources.

Building on this model, EUVABECO’s partner Sciensano, the National Public Health Institute of Belgium, is collaborating with other EUVABECO partners in Luxembourg (Agence eSanté Luxembourg), Poland (Wroclaw Medical University), Greece (University of Crete), and Portugal (General Health Directorate) to adapt and apply the model to other national surveillance systems.

Each of EUVABECO’s partner countries has unique healthcare infrastructures and needs, leading to variations in their implementation strategies. Access to accurate, real-time data is essential to address specific public health questions and develop effective policies. In preparation for pilot implementation in September 2024, each country is currently defining objectives and data requirements while organizing data flows to ensure the strategies are relevant and functional in their contexts.

EUVABECO aims to create adaptable and sustainable data linkage plans beyond the pilot phases, targeting broad adoption across all EU Member States. This involves creating detailed work plans, policy recommendations, outbreak response strategies, and criteria for evaluating the system’s impact, as well as considering financial strategies for widespread implementation. These validated plans will be publically released as part of the EUVABECO implementation packages in 2026.

Want to know more?

For more information about EUVABECO, please contact us directly at contact@euvabeco.net.

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Wednesday 15 May 2024 – EUVABECO convened in Brussels on May 13-14 for a critical session to evaluate progress and outline future strategies. Hosted by Sciensano, Belgium’s national public health institute and EUVABECO partner, the gathering signified a pivotal juncture in the project’s development since its inception in January 2024.

Professor Christos Lionis from the University of Crete, EUVABECO’s coordinator, opened the meeting. He stressed the importance of collaboration and the value of face-to-face interactions in propelling the project towards its objectives. The meeting gathered over 40 representatives including members from EUVABECO’s 14 partnering institutions across Europe, four Expert Advisory Board (EAB) members (with one traveling from the USA), and EUVABECO’s Project Adviser from the European Health and Digital Executive Agency (HaDEA).

Professor Christos Lionis, University of Crete, opens the meeting.

Professor Dace Zavadska of Riga Stradiņš University introduces the Expert Advisory Board.

Participants engaged in discussion over the two days through sessions spanning a variety of essential topics, including the progress made in identifying innovative vaccination practices within Europe, the project’s strategic operations, planning for future implementations, and mechanisms for effective communication and coordination among diverse stakeholders.

Dr. Angus Thomson, a member of the Expert Advisory Board, offers invaluable insights during the session.

There was also an opportunity for informal conversations and connection between partners. These interactions deepened the collective understanding of the challenges and opportunities ahead.

The meeting offered valuable opportunities for informal discussions and connection.

Informal discussions enabled partners and experts to share knowledge on specific challenges.

In the coming months, EUVABECO will transition to its pilot implementation phase. Our forthcoming face-to-face meeting, scheduled to take place before the end of 2024, will be crucial for exchanging insights on challenges encountered early in the pilot phase, and collaboratively developing solutions.

Want to know more?

Contact us directly at contact@euvabeco.net.

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Friday 3 May 2024 – In response to the critical need to restore trust in vaccination programs [1, 2], the European Council proposed a series of actions in 2018 aimed at strengthening cooperation against vaccine-preventable diseases [3]. This led to a 2019 study funded by the European Health and Digital Executive Agency (HaDEA), which explored the feasibility of a European Vaccination Card (EVC) [4]. The study involved analysing existing vaccination documents, creating and evaluating EVC prototypes, assessing public acceptance, and developing strategies for potential EU-wide deployment [5, 6, 7] . Building on these efforts, EUVABECO is now launching EVC pilot projects in Latvia, Greece, Belgium, Germany, and Portugal. The EVC is designed to empower individuals by giving them control over their vaccination data, thus facilitating the management, review, and sharing of their vaccination records as needed. By providing citizens with accurate and current vaccination information, this tool aims to foster informed decision-making, enhance healthcare continuity, and reinforce confidence in both national and European vaccination strategies.

How and why will EUVABECO work with partners to pilot an EU-wide vaccination card?

While the HaDEA-funded study was progressing [8], the COVID-19 pandemic emerged, prompting the European Union to introduce the EU Digital COVID Certificate. This certificate, with over 2.3 billion issued, became a cornerstone of Europe’s pandemic management strategy by facilitating secure travel across the EU and enabling the coordinated relaxation of travel restrictions starting in August 2022 [9]. It also set a precedent for health innovations [10]. Following the expiration of its regulation on 30 June 2023, the World Health Organization (WHO) stepped in to establish the Global Digital Health Certification Network (GDHCN). This foundational digital public health infrastructure was created to meet the ongoing global need for a system that ensures the integrity and bilateral verification of health documents, thereby safeguarding against current and future health crises [11].

The EVC piloted by EUVABECO will use the GDHCN’s trust network, allowing Member States to bilaterally verify the authenticity of digital records through an interoperable trust architecture. While similar to the EU Digital COVID Certificate in being a portable vaccination record, the EVC serves a different purpose. Unlike the certificate, which often fulfilled legal or health mandates, the EVC is specifically designed to empower individuals by granting them control over their vaccination information. This empowerment is crucial for ensuring continuity of care for those crossing borders or transitioning between healthcare systems.

The EVC will be available in various formats—produced on-site, mailed, or digitally downloaded to a smartphone—making it easily accessible and displayable as needed. It will feature comprehensive vaccine history information, including detailed textual records, a scannable QR code, and downloadable embedded metadata. These digital elements, the QR code and metadata, will be securely signed to maintain their authenticity and integrity. Additionally, each vaccine record will be linked to an original master record maintained by a credible health organization, ensuring the data is reliable.

Upon implementation, the EVC will enable individuals to personally manage, access, and control the dissemination of their vaccination data, adhering to privacy regulations that mandate explicit consent for data sharing. Users will have the capability to present the card, which contains their vaccination details, to healthcare professionals and related personnel. Health professionals can then scan the QR code or access the metadata from the card file to include, evaluate, supplement, and confirm vaccination entries within their Electronic Health Record (EHR) system. This process ensures that individuals maintain full control over their health information while preserving the integrity and confidentiality of their medical records.
To realize this ambitious initiative, EUVABECO’s partner organizations in Latvia (Riga Stradins University), Greece (University of Thessaly), Belgium (Fratem), Germany (University of Saarland), and Portugal (General Health Directorate) are now working alongside EUVABECO’s EVC specialists. The successful rollout of the EVC system will depend on dynamic interactions among various stakeholders and system components, including an electronic Patient Information Leaflet (ePIL) server, a terminology server, a global registries directory, health jurisdiction registry, and a master records repository.

Each participating country brings unique resources to the table, such as existing Electronic Health Records, Immunisation Information Systems, and paper cards, each with differing vaccine terminologies. One significant challenge is the harmonization of vaccine terminology across these diverse healthcare settings, which will require developing a common syntax—a challenge EUVABECO is poised to tackle.

Acknowledging the varied healthcare landscapes in these countries, EUVABECO is committed to devising and refining implementation plans that are not only effective but also adaptable, and sustainable. The objective extends beyond the pilot phases, aiming for the broad adoption of the EVC across all EU Member States. This will involve the creation and dissemination of detailed workplans, the formulation of policy recommendations, and the development of strategies for outbreak response, alongside establishing criteria for evaluating the system’s impact and considering financial strategies for its widespread implementation.

Want to know more?
Contact us directly at contact@euvabeco.net.

References

[1] European Commission (2020). State of Vaccine Confidence in the EU+UK 2020. doi:10.2875/06196 EW-03-20-831-EN-N (https://health.ec.europa.eu/document/download/33ad08ec-1f2c-46e8-be37-fc4c523447ab_en, accessed 6 April 2023)

[2] Guaraldi F, Montalti M, Gori D. The importance of mapping determinants, attitudes and beliefs of vaccine hesitancy in the great challenge of compulsory childhood vaccination: Comment on “Convergence on coercion: functional and political pressures as drivers of global childhood vaccine mandates.” Int J Health Policy Manag. 2023;12:7614. doi:10.34172/ijhpm.2023.7614 (https://pubmed.ncbi.nlm.nih.gov/37579365/, accessed 6 April 2023)

[3] European Commission (2018). COUNCIL RECOMMENDATION of 7 December 2018 on strengthened cooperation against vaccine-preventable diseases (2018/C 466/01). (https://eur-lex.europa.eu/legal-content/GA/TXT/?uri=OJ%3AJOC_2018_466_R_0001, accessed on 6 April 2023)

[4] European Commission (2019). Chafea/2019/Health/07 Concerning the Provision of Options and Recommendations for an EU Citizens’ Vaccination Card (https://ted.europa.eu/udl?uri=TED:NOTICE:40632-2020:TEXT:EN:HTML, accessed on 6 April 2023)

[5] European Commission (2022). Provision of options and recommendations for an EU citizen’s vaccination card. Annex 1, Data collection and mapping [report] (https://op.europa.eu/en/publication-detail/-/publication/6cf30f19-6a36-11ed-b14f-01aa75ed71a1/language-en/format-PDF, accessed 11 April 2024)

[6] European Commission (2022). Provision of options and recommendations for an EU citizen’s vaccination card. Annex 2, Design and testing of three dual templates [report] (https://op.europa.eu/en/publication-detail/-/publication/da6517a7-de58-11ed-a05c-01aa75ed71a1/language-en/format-PDF/source-search, accessed 11 April 2024)

[7] European Commission (2022). Provision of options and recommendations for an EU citizen’s vaccination card [report] (https://op.europa.eu/en/publication-detail/-/publication/111d0610-1c41-11ed-8fa0-01aa75ed71a1/language-en/format-PDF/source-search, accessed 11 April 2024)

[8] European Commission (2019). Chafea/2019/Health/07 Concerning the Provision of Options and Recommendations for an EU Citizens’ Vaccination Card (https://ted.europa.eu/udl?uri=TED:NOTICE:40632-2020:TEXT:EN:HTML, accessed on 6 April 2023)

[9] European Commission. EU Digital COVID Certificate [web portal] (https://commission.europa.eu/strategy-and-policy/coronavirus-response/safe-covid-19-vaccines-europeans/eu-digital-covid-certificate_en, accessed 11 April 2024)

[10] Kaag, F., and Koeck, JL (2021). EU COVID pass paves the way for digital vaccination card. Vaccines Today [news article] https://www.vaccinestoday.eu/stories/eu-covid-pass-paves-the-way-for-digital-vaccination-card/

[11] World Health Organization. Global Digital Health Certification Network [web portal] (https://www.who.int/initiatives/global-digital-health-certification-network, accessed 11 April 2024)

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Thursday 25 April – the EUVABECO (European Vaccination Beyond COVID-19) initiative is advancing with the introduction of five innovative tools, including a key Clinical Decision Support (CDS) system, aimed at enhancing the vaccination experience and increasing the efficiency of vaccination programs. Building on the success of a system previously deployed in France and Luxembourg, EUVABECO will initiate pilot programs in Latvia, Belgium, Greece, Poland, and Portugal. The CDS system taps into vast datasets to provide vaccination advice tailored to the specific health profiles of individuals. This empowers patients with personalized vaccination information and supports healthcare providers in making informed vaccine administration decisions. By enhancing access to detailed, up-to-date information, CDS have the potential to build confidence in vaccination.

How and why will EUVABECO work with partners to deploy a Clinical Decision System for vaccination?

A one-size-fits-all approach to vaccination, though straightforward, overlooks the unique needs of individuals. The risk of exposure to infectious diseases and the severity of the potential disease vary greatly among people. It is therefore crucial for vaccination programs to target those who will benefit the most, whether they are the vaccine recipients themselves, or members of their community. For example, the bacille Calmette–Guérin (BCG) vaccine for tuberculosis, previously universally administered across Europe [1], is now primarily recommended for children up to 6 years old who are at an increased risk of TB infection [2].

This concept of customization finds a parallel in World War II when the United States Air Force undertook a project to design an “average” cockpit based on measurements from thousands of pilots. Despite comprehensive planning, the project encountered setbacks as most pilots did not fit the “average” mold, leading to the innovative solution of adjustable seats. This adaptation allowed cockpits to accommodate pilots of various sizes, highlighting the importance of an individualised approach [3].

The EUVABECO initiative embodies this adaptive philosophy in healthcare by introducing a Clinical Decision Support (CDS) system. Vaccination CDS are designed to navigate the complex landscape of vaccine decision-making, integrating scientific evidence, health considerations, and diverse guidelines to tailor vaccine recommendations to individual health profiles.

CDS synthesize data from a broad spectrum of sources, including electronic vaccination cards, international patient summaries, historical and electronic health records, local vaccination guidelines, and direct patient feedback through questionnaires [4]. This integration allows for an exhaustive evaluation of factors like demographics, living conditions, employment status, medical and vaccination history, family situations such as the arrival of a newborn, chronic conditions, and serological test results, ensuring the CDS offers guidance that is both accurate and personalised.

In France, the perceived value of the CDS to the health workforce has been particularly apparent in recent months, as many pharmacists, who were recently authorized to prescribe and administer vaccines [5], have quickly adopted a CDS tool [6]. Assistant Pharmacist Sophie Bender noted that these tools “motivate patients to get vaccinated, especially for often overlooked vaccines like Meningococcal C”. Meanwhile, Pharmacist Anne Andraud highlighted that the CDS “provides reliable, personalized vaccination information, enhancing our advisory role and facilitating meaningful interactions with patients, which is crucial today” [7].

EUVABECO’s partner organizations in Latvia (Riga Stradiņš University), Belgium (Fratem), Greece (University of Thessaly), Poland (Jagiellonian University), and Portugal (Directorate-General of Health) are now set to work closely with EUVABECO’s CDS specialists to adjust a CDS system of their choice to their specific local context. This will include translating vaccination guidelines, customizing the system for local healthcare settings, crafting justification messages and questionnaire items, and conducting pilot tests to ensure the system’s recommendations are accurate and reliable.

Considering the diverse healthcare environments in these countries, including differences in epidemiological trends, immunization information systems, vaccine nomenclature, and collaboration dynamics with National Immunization Technical Advisory Groups (NITAGs), EUVABECO is dedicated to crafting and assessing implementation plans that are effective, adaptable, and sustainable in various healthcare landscapes. The ultimate goal is to disseminate these rigorously tested implementation plans to all EU Member States, enabling a wider uptake of vaccination CDS. These comprehensive plans will include detailed workplans, policy recommendations, strategies for outbreak response, criteria for assessing the system’s impact, and financial considerations for its implementation.

Want to know more?

Contact us directly at contact@euvabeco.net.

References

[1] Dara et al. (2014). Bacille Calmette–Guérin vaccination: the current situation in Europe. European Respiratory Journal 2014 43: 24-35 [publication] (https://erj.ersjournals.com/content/43/1/24#:~:text=During%20the%20first%20half%20of,specifically%20in%20tuberculosis%2Dendemic%20areas, accessed April 3 2024).

[2] European Centre for Disease Prevention and Control. Vaccine Scheduler. Tuberculosis: Recommended vaccinations [web portal] (https://vaccine-schedule.ecdc.europa.eu/Scheduler/ByDisease?SelectedDiseaseId=14&SelectedCountryIdByDisease=-1#:~:text=BCG%20vaccination%20is%20recommended%20for,planned%20longer%20(more%20than%20three, accessed April 3 2024).

[3] Daniels, G. (1952). The “Average Man”. Wright Air Development Centre. DOI: 10.21236/AD0010203 (https://scholar.archive.org/work/bpknco4mhfcjbhesnjt2me4dea, accessed April 3 2024).

[4] MesVaccins. Vaccine Recommendations [web portal] (https://mentor.mesvaccins.net/en-gb, accessed April 3 2024)

[5] République française. Service-public.fr. Le site officiel de l’administation française [web portal] (https://www.service-public.fr/particuliers/actualites/A16732?lang=en, accessed April 3 2024)

[6] MesVaccins subscription data (personal communication)

[7] Personal communication with Francois Kaag (Syadem) and Jean-Louis Koeck (Syadem)

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