WAidid suggests to read the consensus points from a pan-European meeting held under the auspices of World Association for Infectious Diseases and Immunological Disorders (WAidid) and Vaccine Study Group of the European Society of Clinical Microbiology and Infectious Diseases (EVASG) and supported by Vaccines Europe.

INTRO

• Premise

The proportion of the people >65 years old will be about 27% in 2050 worldwide, but in many European countries will increase to more than 40% by 2040. Individual disabilities associated with an ageing society is a social and economic burden to all.

A pan-European meeting -with more than 40 people representing stakeholder (public health,

research physicians, patients, regulators and manufacturers) in the area of vaccines and vaccination- made the point on how to overcome barriers and gaps to make vaccination of the population >50 years old a reality in Europe.

The main goal is promoting a healthy and active ageing in Europe through a rational use of vaccines, so preventing infectious diseases that are cause of many disabilities.

The meeting was held under the auspices of World Association for Infectious Diseases and Immunological Disorders (WAidid) and Vaccine Study Group of the European Society of Clinical Microbiology and Infectious Diseases (EVASG) and supported by Vaccines Europe.

CONSENSUS POINTS

• The burden of disease due to …
• Influenza

Causes every year 40.000 deaths in the EU (90% of which occur among persons aged = 65 years); complications leading to hospitalizations (78 cases per 100,000 inhabitants every year) and permanent disability.

• Herpes zoster

is a disease caused by the reactivation of a latent chickenpox virus (varicella zoster virus) infection strongly age-dependent: at 50 years, the number of cases increases to 7–8 and at the age of 80 years to 10 cases. The characteristic skin rash evolves into vesicles, which ulcerate and heal within a month; in about 20% of cases, the subjects suffer from complications.

• Pneumococcal pneumonia

is a common cause for hospitalizations among the elderly and can be fatal in about 12% of patients

Diseases like influenza, pneumococcal diseases and shingles can increase the occurrence of some cardiovascular complications. For all these diseases, although some countries implemented vaccination programs for elderly, coverage is frequently lower than expected.

• Childhood diseases are becoming diseases of the adults: A lifelong approach to vaccination is required

Vaccination in children gives an indirect protection of other age groups, by preventing the infectious agent from spreading. However, vaccination coverage is suboptimal. It is important, if not necessary, a mindset shift from childhood to life-long vaccination.

• The life-long approach to vaccination

To support and implement effective life-long vaccination we need to shift the mindset of politicians from treatment (80% of current budget) to prevention (5% of current budget) inducing them to perceive vaccination as an investment for the future rather than a cost. Changing the future policy making is a crucial point. Moreover, it is important not only implement vaccination coverage rate, but also monitoring its impact on population.

• Moving towards an optimization of vaccination calendars and the role of the eu institutions

To achieve a certain degree of harmonization in vaccination rate it is desirable to otimise the policy-making structure by developing joint action programmes between both Member States and the Commission to share best practices, together with the European Center for Disease Prevention and Control (ECDC), European Medicines Agency (EMA) and World Health Organization (WHO) Europe.

• Challenges in the post-truth, media-based era

If evidence is not enough… How communicate the evidence supporting life-long vaccination in the media-based era, based on emotions and not on scientific evidence. This is the challenge to face in order to shape public opinion and get vaccines used, not only approved.

• The transformation team

To shift the mindset of the public it is necessary to have effective and innovative communication strategies and, moreover, a multidisciplinary team including sociologists, cultural anthropologists, behavioral psychologists, risk communication experts, social media and social marketing experts who are able to convey messages in the right and effective format.

• Implementation: last, but not least

Remove practical barriers to vaccination by national preventing and check-up programs and provide the availability of an electronic immunization record could be helping to succeed in the challenge of adult immunization. Moreover, healthcare professionals have to be board and trained.

• Italy to spearhead the shift

Italy made an important step toward life-long vaccination with its ‘vaccination calendar for life’, that has been already approved and implemented. It includes vaccination against hepatitis B and measles-mumps-rubella-chickenpox for all susceptible adults; meningitis (4 types) and influenza for all adults; vaccination against pneumococcal pneumonia and herpes zoster for people >64years.

• Conclusions

The shift from childhood to life-long vaccination requires an innovative approach and a certain number of key actions. For these actions, a European multidisciplinary network including health authorities, medical doctors with different specialties, sociologists,

Psychologists, pharmaceutical companies and Associations of patients appears mandatory.

AUTHORS: Susanna Esposito, Nicola Principi, Giovanni Rezza, Paolo Bonanni, Gaetan Gavazzi, Ingo Beyer, Michael Sulzner, Lucia Pastore Celentano, Roman Prymula, Andrea Rappagliosi, Joseph Sevilla, Gregory Poland, for the WAidid-EVASG Panel on vaccination of 50+