With people more aware than ever before of the valuable role vaccination can play in protecting public health, we must take this window of opportunity to increase vaccine uptake against other preventable respiratory diseases, urges Pfizer’s Sinan Atlig.
Throughout the pandemic, public health bodies have reinforced the vital role of routine immunisation of older and vulnerable adults against vaccine preventable respiratory diseases (VPRDs), such as flu and pneumococcal pneumonia. In doing so, public health can be maintained, and healthcare systems protected against further strain.1
Despite this, the World Health Organization reported significant disruption to routine immunisation services throughout the COVID-19 pandemic.2 While travel restrictions, mask-wearing and social distancing reduced the risk of transmission of COVID-19 and other respiratory diseases, the lifting of these measures heading into winter across Europe could bring a long-term rise in outbreak-prone VPRDs. So, what can we do to mitigate this risk?
Our ‘North Star’ must remain, that, second only to clean water, immunisation is the most effective public health intervention of all time – yet it has taken the COVID-19 pandemic to remind us of this. We are seeing real world data on the impact of COVID-19 vaccination beginning to emerge across Europe, with recent data estimating that the COVID-19 immunisation programmes have prevented up to 98,700 deaths in England3, 47,000 deaths in France4 and 38,000 deaths in Germany.5
“I urge governments to update access policies for existing and novel vaccines in the light of lessons learned during the pandemic”
In addition to a demonstrated impact on protecting health, immunisation is also one of the most successful measures to maintain economies – with an annual return on investment of up to 18% globally.6 With a reduction in GDP due to the pandemic response, and without clear guidance and protection of investment, there is very real risk that funds could be diverted from routine immunisation throughout the life course. Pandemic immunisation programmes have already exerted significant pressure on vaccination infrastructure and the potential impact of reduced investment in routine immunisation requires careful mitigation.
While political pressure may still be focused primarily on the COVID-19 pandemic, helping to ensure protection against all VPRDs is vital to save lives, protect health, maximise healthcare capacity and avert long-term consequences. Diseases caused by respiratory pathogens including flu and pneumonia undoubtably put pressure on healthcare systems – with the average estimated hospital stay for pneumonia being 12 days. With reduction in hospitalisations from VPRDs, healthcare resources can be directed to improve health outcomes for individuals most affected by the pandemic, particularly during winter months.
I urge governments to update access policies for existing and novel vaccines in the light of lessons learned during the pandemic, to optimise strategic decisions regarding immunising people at-risk from VPRDs. Provision of vaccination by pharmacists, as we saw during the pandemic, is just one way to strengthen health system capacity and increase community vaccine coverage. There is now a window of opportunity to build on the 2021/22 expanded flu vaccination programmes to check pneumococcal vaccination status and prioritise immunisation of vulnerable people. Countries like the Netherlands are leading the way, with all those at high risk from COVID-19 being vaccinated against pneumococcal disease.7
It will also be essential to protect and expand budgets for ongoing and novel immunisation programmes, for diseases where current targets are not being met and with the same urgency as childhood vaccination. This will help ensure that every patient touchpoint is utilised so that at-risk adults are fully protected with the available vaccines for respiratory diseases in preparation for the 2021/22 winter season and beyond.
1 Public Health England (2021). Why we are preparing for a worst-case scenario winter season. Available at: https://publichealthmatters.blog.gov.uk/2021/07/23/why-we-are-preparing-for-a-worst-case-scenario-winter-season/ Last accessed: September 2021.
2 WHO. Immunization services begin slow recovery from COVID-19 disruptions, though millions of children remain at risk from deadly diseases – WHO, UNICEF, Gavi. Available at: https://www.who.int/news/item/26-04-2021-immunization-services-begin-slow-recovery-from-covid-19-disruptions-though-millions-of-children-remain-at-risk-from-deadly-diseases-who-unicef-gavi/ Last accessed: September 2021.
3 Public Health England (2021). COVID-19 vaccine surveillance report Week 33. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1012420/Vaccine_surveillance_report_-_week_33.pdf. Last accessed: September 2021.
4 Sofonea M, Boennec C, Fontalirant A, et al. Quantifying the real-life impacts of vaccination on critical COVID-19. OSF Preprints. 2021. DOI 10.31219/osf.io/6ebxu
5 DW. German vaccination campaign saved thousands of lives: study. Available at: https://www.dw.com/en/german-vaccination-campaign-saved-thousands-of-lives-study/a-58793095. Last accessed: September 2021
6 WHO (2008). Bulletin of the World Health Organization: Vaccination Greatly Reduces Disease, Disability, Death And Inequity Worldwide. Available at: www.who.int/bulletin/volumes/86/2/07-040089/en/. Last accessed: September 2021.
7 National Institute for Public Health and the Environment (2021). Frequently asked questions about the flu jab, pneumococcal vaccination and COVID-19. Available at:https://www.rivm.nl/en/frequently-asked-questions-about-flu-jab-pneumococcal-vaccination-and-covid-19. Last accessed: September 2021.
Only by working together as a community and investing in public health together can we protect society’s most vulnerable, says Sara Cerdas.
As COVID-19 swept the globe, public health became a far more familiar subject to the general public than ever before. However, public health goes far beyond pandemics. It was defined by the WHO in 1988 as ‘The art and science of preventing disease, prolonging life and promoting health through the organised efforts of society’. In other words, it is how we can work together as a society to live longer and healthier lives.
Public health interventions are highly cost-effective, but they often take a long time to achieve their intended outcomes. For each euro invested in long term public health intervention, we receive 14 euros in return1. Historically, the two most significant public health advances were sanitation (clean and secure tap water and sewage) and vaccination. Today, all of us recognise the importance of having clean water in our homes and a sewage system that prevents the proliferation of deadly pathogens. Vaccination should have the same status.
COVID-19 is a disease that affects everyone. It could perhaps best be described as a ‘healthcare services destroyer’, given its impact on those suffering from mild to severe symptoms, stressing the resources of national healthcare services around the globe. As the pandemic continues, we learn more and more about the virus, and, through an unprecedented global effort, we managed to develop vaccines to fight it. Why is this important? It is thanks to vaccination efforts that fewer people require specialised care, freeing up our healthcare services to take on all the other diseases and risk factors that were ‘left behind’.
"It is thanks to vaccination efforts that fewer people require specialised care, freeing up our healthcare services to take on all the other diseases and risk factors that were ‘left behind’”
With winter fast approaching, it is important to understand which diseases are more prevalent this season and how to avoid them. Every winter, healthcare services are overwhelmed by an increase in respiratory diseases such as influenza and pneumonia, among others. Flu and pneumonia are vaccine preventable diseases that have a great impact on mortality and morbidity in our societies, with personal, social and economic consequences.
For this reason, it is important to promote immunisation programmes of vaccine-preventable respiratory diseases alongside health literacy, to increase preventative behaviours that should be reinforced during the coldest months, and also to reduce misinformation and build vaccine confidence.
Investment in programmes and actions that have proven their efficacy in improving public health is needed. Evidence shows that vaccination works for both the individual and the community, as herd immunity protects those who cannot be vaccinated due to their health condition. Investing in public health is investing in our communities.
Sara Cerdas (PT, S&D) is a member of Parliament’s Environment, Public Health and Food Safety Committee
1Masters et al. (2016) Return on investment of public health interventions: a systematic review. BMJ Journal of Epidemiology and Community Health.
Brought to you by Pfizer