Vaccine performance needs careful and independent evaluation
Independent evaluation is key to ensuring public confidence in vaccines, says Jim McMenemin.
Public confidence in vaccines is fragile. It is often negatively impacted by ant-vaccine groups, media questioning and by perceived conflicts of interest between researchers and producers. The success of immunisation programmes against childhood and adult vaccine preventable disease has also led to a drop in concern resulting in gaps in vaccination coverage.
It is important to ensure that people have confidence in vaccines by demonstrating that their effectiveness and safety evaluations are carried out independently from funding and commercial pressures.
This independence is particularly important when communicating on vaccine recommendations. There are two different funding and governance models for measuring vaccine performance at EU level.
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One model excludes industry from funding and governance through processes such as funding through the European Commission's Research DG (the I-MOVE+ project funded through Horizon 2020 for example), or by EU agencies such as the European Centre for Prevention and Disease Control (ECDC) funding for I-MOVE, SpIDnet and PERTINENT projects.
The other includes industry in the funding and governance in the context of public-private partnerships such as the Innovative Medicines Initiative-funded ADVANCE project.
In the industry-independent model all four projects are funded with EU member state and Commission financial support and include 18 EU/EEA member states and 34 partners including national or regional public health and universities, with their networks of general practitioners, laboratories and hospitals.
They measure vaccine-effectiveness against influenza, pneumococcal and pertussis infections as well as the impact of vaccination strategies.
These projects funded with EU public money have ensured the provision of vaccine effectiveness estimates for influenza in each season as well as guiding policymaking at national, European and WHO level (WHO committee on influenza vaccine strain selection) in a timely manner.
They help in identifying new and emerging pneumococcal strains and resistance to antibiotics. They also improve our understanding of the rate and severity of infant whooping cough.
During annual workshops European, Pan-American and Australian experts review each project's methodological and operational aspects. These results are then discussed with national, EU and WHO public health authorities.
The performance of vaccines, need to be carefully evaluated using appropriate and independent studies. This is currently accomplished through funding from the Commission and its agencies.
It needs to be extended to all vaccine preventable diseases through EU mechanisms and scientific networks that ensure rigorous science and complete scientific independence from commercial pressures.
The current Commission funding stream and governance model, which are independent of the pharmaceutical industry, have allowed the development of large EU networks that could not otherwise have been possible through the use of joint public-private ventures.
Furthermore, most member states do not permit public-private partnerships for national disease surveillance, evaluation of vaccine performance or for communicating on vaccine recommendations.
Therefore, we believe that studies evaluating vaccine performance should be conducted independently from funding sources guaranteeing scientifically rigorous independent evaluation without jeopardising public confidence.
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