Quarterly Newsletter:

October 2021

Issue #2

Editorial

We can’t let our guard down! 

The COVID-19 pandemic has challenged the resilience of our health systems in an unprecedented way. Immunisation, a key pillar of our health systems, has not been spared. More than 5% drops in immunisation coverage in WHO EU countries; declines below the 95% regional target rates in various EU countries; and in Greece a 45% drop in HPV vaccination in the 11-16 age group. And the upcoming influenza season poses an additional threat to our weakened health systems, exhausted health professionals and a complacent population. We cannot let our guard down! 

Immunisation policies in Europe need strong political leadership and timely monitoring of vaccination. The pandemic demonstrated that with these foundations, achieving 70% coverage rates in 9 months in most EU member states was mission possible. Such a target had previously been elusive even for influenza, which causes up to 70,000 deaths in the EU annually. With a measles outbreak always on the horizon, the silent epidemic of HPV-related cancers that continue to infect our young people, and influenza threatening to collapse our health systems, we need timely monitoring of vaccination rates. 

So how can we get there? EU member states need to consider performant immunisation systems as a priority of EU4Health to build resilient health systems. This would not be achievable without sustainable immunisation financing. Underinvestment contributed to gaps and delays in the roll-out of (COVID-19) vaccination in the adult population, and failure to maintain routine vaccination services during the pandemic. Almost 80% of EU countries spend less than 0.5% of their healthcare budget on immunisation, whereas effective routine immunisation programmes could protect against up to 20 infectious diseases and related cancers across the life-course. 

There is a significant lack of understanding of how immunisation programmes are financed, as well as a lack of strategic perspective on the contribution to public health – with their costs sometimes mistakenly considered as spends rather than investments. In fact, we know that vaccines are at least paying for themselves. Influenza outbreaks alone, result in a GDP loss of approximately 0.5–2%. 

Last September 10 2021, I participated in the EU4Health webinar and presented on how the EU4health programme could be a turning point for sustainable immunisation financing across Europe. Building on the framework established by the Joint Action on Vaccination, the EU4Health Programme could support:  

1)  the development of a comprehensive report on the financing of immunisation programmes in 27 EU Member States;

2)  establishing a stakeholder platform with EU Member States to share learnings on immunisation programme financing and performance; 

3)  providing additional funding for the implementation of immunisation programmes in low-performing areas, with the aim of those areas reaching autonomy in immunisation financing.

We need to get better at understanding the structures and trends driving immunisation financing. This will help keeping our guard up by raising coverage rates and introducing innovative vaccines for increased population protection.  

Sibilia Quilici, Executive Director Vaccines Europe

Key Figures

Vaccines Europe External Engagement

#EUFluDay event: One voice to protect populations from flu in the age of COVID-19

Hosted by MEP Dolors Montserrat and the Steering Group on Influenza Vaccination, the webinar One voice to protect populations from flu in the age of COVID-19 brought together key stakeholders in the area of vaccination to mark the second annual EU Flu Day. Speakers shared their perspectives on the COVID-19 pandemic’s spill-over effects on influenza vaccination, and what needs to be done to protect European populations and healthcare systems in the upcoming influenza season.

In the context of the EU Flu Day, and to stress the important role of healthcare professionals, the Steering Group on Influenza Vaccination has sent an open letter to the European Commission calling for increased efforts at EU-level to protect healthcare professionals from influenza.

Event: Building the European Health Union together - for better public health in Europe

We held a webinar on building the European Health Union (EHU) together, for better public health in Europe. We thank all participants and attendees for their insightful contributions to an interesting discussion.

Key highlights:

• We echo MEP Sara Cerdas’ strong message: “Vaccination is one of the greatest achievements of humanity”. The European Parliament is playing an essential role in putting health promotion and disease prevention on top of the agenda, especially with this important legislative package.
• Experts agreed that platforms for close and continuous dialogue and collaboration between all stakeholders – at all levels – will be an absolutely essential part of the EHU.
• “Let’s not forget that it is not just about response; it is also about preparedness – the better we are prepared, the easier it will be”, Marco Cavaleri (European Medicines Agency) highlighted the importance of working together towards the goal of achieving better preparedness.
• As explained by Isabelle Bekeredjian-Ding: the COVID-19 pandemic has clearly shown that the European Centre for Disease Prevention and Control (ECDC) has not yet gained the significance or relevance that it should. The ECDC has the potential to become a vital focal point for data collection, as well as a platform for dialogue between Member States and key institutions in crises and beyond.
• Sibilia Quilici, Executive Director Vaccines Europe, concerned by the limited number of vaccine experts in the European network, called for structures to have close collaboration with the vaccine industry, to share expertise, protocols, and avoid unnecessary duplication of resources that would undermine the quality of important post marketing studies. The vaccine industry plays a critical role not only in pandemic preparedness – as COVID-19 has shown – but also beyond the pandemic. This will help to prepare in advance, react fast and respond better to future health threats.
• Panellists agreed that the EHU is a good starting point which will fundamentally change how we respond to health threats in the future. However, as explained by Richard Price (European Cancer Organisation), to optimise the potential of the EHU, it needs to be seen as an open piece of legislation so that we can return and amend as needed throughout the years.

Communications Highlights

Podcast: What is needed from the ECDC to be better prepared for future health threats?

The COVID-19 pandemic has shown the need to improve EU health threat preparedness. Listen to our podcast with Prof. Paolo Bonanni, MD, Professor of Hygiene & Public Health, University of Florence, Prof. Dr. Joe Schmitt, Editor in Chief, Global Health Press and Sibilia Quilici, Executive Director Vaccines Europe, where we explore what is expected from the European Centre for Disease Prevention and Control (ECDC) to address future challenges.

Zoom in on Market Access for Vaccines

The speed at which we developed safe and effective COVID-19 vaccines, and the ways in which pioneering new technologies have been at the forefront of this leap forwards, have given us a glimpse into the future. We have all been shown what the next generation of vaccines could look like. This vaccine innovation could lead to several diseases being controlled, eliminated and even eradicated in a way that would have seemed impossible just a few years before. 

 But while innovation is one core element of this great achievement, another is equally essential to consider. For these ground-breaking new vaccines to reach Europe’s citizens, we need systems that ensure their effective introduction. The question is then: how can we achieve fast and efficient access using the tools at our disposal? 

When a median time to access to vaccination is 6 years across the EU, the sense of momentum in response to the COVID-19 pandemic should stimulate implementation of policies to improve access to all vaccinations across the EU. 

Central to the answer is the Health Technology Assessment (HTA) Regulation, for which a provisional Agreement was reached just before summer this year. This Regulation is an essential tool for tackling unnecessary administrative and regulatory barriers to patients' access to innovative medical products. However, there are key issues outstanding – pertaining in particular to the specificities of vaccines. 

Vaccines are unique for a variety of reasons, especially due to their wide-ranging and positive impact on society, but also their significant economic and socioeconomic impact - which was made clear more than ever during the COVID-19 pandemic. 

We cannot afford to ignore the broad value of vaccination in the implementation stage of the HTA Regulation – in terms of processes, relevant expert-stakeholders involvement and assessment methodologies. 

Overall, we are therefore calling for: 

• Establishment of a European Vaccine Clinical HTA Committee 

• Development of vaccine-specific methodologies and processes for clinical HTA assessment of vaccines 

• Vaccines to be considered in the later stage of the phase-in period of the Regulation’s implementation, given the need to develop specific and appropriate processes and guidelines 

• Systematic and continuous involvement of vaccines companies in the future Joint Clinical Assessment (JCA) process, including the scoping and appeal mechanism 

You can read our full position paper on the joint clinical HTA for vaccines here and the corresponding Blog by the Chair of Vaccines Europe’s Market Access Working Group & Market Access Director Europe, MSD. 

Want to deep-dive into vaccine market access pathways in the EU27 and the UK? Read a unique research-based article from Vaccines Europe, recently published in the Vaccine journal here. 

Building confidence in COVID-19 vaccination through human storytelling – an example from Ireland 

Early in 2021, Ireland was middle of the table when it came to vaccine hesitancy and rollout of COVID-19 vaccines. Now, as we approach 2022, Ireland is among the least COVID-19 vaccine-hesitant countries in the world, and its vaccination rollout campaign has been among the fastest anywhere. 

One enabler for reaching these milestones was the vaccine industry’s campaign to strengthen public understanding of the value of vaccines and why getting protected against COVID-19 was the route back to living again. The campaign, run by the Irish Pharmaceutical Healthcare Association, used facts and human storytelling to position vaccination as a safe and effective public health intervention during a pandemic.

Their approach included: 

• Creating a range of documentary-style films, motion graphics and infographics to messaging on science, safety and speed, as well as the regulatory and development process for vaccines.
• Providing a human dimension. They cast their real-life storytellers – Sarah, who wanted her parents to meet her new baby; Stephen who wanted to get back to volunteering at the rugby; Rosie who wanted to feel safer because she has an underlying health condition; and others.
• Organising a virtual thought leadership event, as part of their Forum series, bringing together patient advocates, scientists, social media experts and behavioural scientists. The event drew some 200 people.
• Tracking public sentiment around vaccines, in partnership with pollsters Ipsos MRBI, to get actionable data on public opinion. 
• Using a mix of earned media across news and opinion to reinforce their messaging across social platforms.
• Aligning with public health messaging used by the Government and the public health authorities. 

Find out more about the initiative here, here and here.

Their focus now turns to life-course immunisation - making the case to the public for why it’s important to guard against all vaccine-preventable diseases.

What We Are Reading & Watching

Investigating the procurement system for understanding seasonal influenza vaccine brand availability in Europe: an article published in PLoS ONE

Working Towards a Sustainable, Healthy Market for Vaccines: a Comprehensive Framework to Support Policy Dialogue and Decision-Making: a consulting report by OHE

Sustainable immunisation financing: an event and a blogpost by ThinkWell