«I feel that the greatest reward for doing is the opportunity to do more.» – Dr. Jonas Salk
THE SITUATION
Vaccination is widely considered one of the greatest medical achievements of modern civilization [1]. Nevertheless, since the early introduction of this intervention, public concerns about vaccine safety have always accompanied vaccination efforts. Despite these concerns, recent data collected by the World Health Organization (WHO) show that in 2018 several vaccines achieved coverage rates of over 95% in Europe [2].
However, since 2016 the WHO has reported enormously increasing numbers of measles cases [3].
Of all countries in the European region, Ukraine reported the highest number of cases: since the beginning of this year, 56.861 people got measles in Ukraine – 26.748 adults and 30.113 children, with 18 people deceased due to measles complications. One of the main reasons for low vaccine coverage in Ukraine is lack of proper training at medical universities. According to recent research, almost 30% of surveyed medical students believe that it is better for a child to acquire immunity by getting sick, rather than through vaccination. Almost 60% of the medical students reported that they believe vaccines may cause autism [4]. Moreover, the ignorance concerning vaccines is alarmingly prevalent even among Ukrainian infectious disease experts.
HOW DOES THIS AFFECT CHILDREN IN EUROPE?
Measles is a highly infectious viral disease which can lead to serious complications such as pneumonia and encephalitis. It is still a major cause of death: according to the WHO, in 2017 there were 110.000 measles deaths globally, mostly among children under the age of five, even though a safe and cost-effective vaccine is available. In the meantime,Four countries in the European Region lost their measles-free status: Albania, Czech republic, Greece and the UK. [5]). The principles of herd immunity are also vital to those too young to receive the vaccinations, and those who are immunocompromised.
Healthcare workers’ knowledge and practices are influential factors in preventing vaccine failures, hesitancy amongst parents and caregivers and the spread of false information.
CURRENT GOOD PRACTICES
One of the ways to solve the existing problem is proper education. That is why the Ukrainian Academy of Paediatric specialties (UAPs), a professional society from Ukraine – inspired by already existing events such as the Antwerp Summer School on Vaccinology [6] – decided to organise the 1st Ukrainian Summer School on Vaccinology [7].
The School was designed for young specialists who work in primary care –general practitioners (GPs) and paediatricians –, that is to say, those who carry out the immunisation process first-hand. This year 51 physicians from all over Ukraine came to participate (those who came from the Donetsk region, close to military actions, took about 28 hours to travel to the event). The program of the summer school included 20 lectures (topics from basic principles of immune response to crisis communication), a practical session and a final assessment.
This initiative was made possible with the dedicated support of the European Society of Paediatric Infectious Diseases (ESPID).
The European Academy of Paediatrics (EAP) was one of the first world known organisations to support Ukraine during this outbreak, not only by word [8], but also through the following actions:
– personal visit of the EAP president – Prof. Adamos Hadjipanayis;
– active participation of the chairman of the EAP vaccination working group – Prof. Hans Jürgen Dornbusch – in the 1st Ukrainian Summer School on Vaccinology.
OUR RECOMMENDATIONS
-Young EAP and EAP strongly support the WHO recommendations for European countries to make immunization a priority and to strive to a Europe free of vaccine-preventable diseases [9].
-We believe that organising proper education in vaccinology – through basic medical education curricula or professional bodies (like the UAPs in Ukraine) – is one of the most important ways to tackle decreasing vaccination rates [10, 11].
-Through increased and focused education of health care personnel directly involved with parents/caregivers (e.g. paediatricians, nurses, practice assistants), correct information about vaccines will reach the patient. Vaccination record checking should be a part of every routine medical visit, and attention should also be paid to vaccination of parents.
-Health care personnel should also be able to discourage vaccination hesitancy by addressing misinformation, rumors or fakenews on this topic [12].
-We also believe that vaccination campaigns should use social media and influencers to spread evidence-based information about vaccines and maintain a positive media environment. The media shouldbe held accountable when spreading false information on vaccines or vaccine preventable diseases.
About the authors:
List of Authors
Yevgenii Grechukha (Ukraine) is a member of Young EAP and chair of the young committee of UAPs. He is a paediatric trainee at the Bogomolets Medical University, Kyiv, Ukraine.
Andreas Trobisch (Austria) is a member of Young EAP. He is a paediatric trainee at the Medical University of Graz, Austria.
Siel Daelemans (Belgium) is a member of Young EAP. She is a general paediatrician subspecializing in pulmonology and infectious diseases at the University Hospital of Brussels, Belgium.
References
New ways to test high-risk medical devices.
Manufacturers of medical devices need to test their products before being allowed to market them. Specifically, they require clinical data showing their medical device is safe and efficient. In this context, the EU-funded CORE-MD project will translate expert scientific and clinical evidence on study designs for evaluating high-risk medical devices into advice for EU regulators. The project will propose how new trial designs can contribute and suggest ways to aggregate real-world data from medical device registries.
It will also conduct multidisciplinary workshops to propose a hierarchy of levels of evidence from clinical investigations, as well as educational and training objectives for all stakeholders, to build expertise in regulatory science in Europe. CORE–MD will translate expert scientific and clinical evidence on study designs for evaluating high-risk medical devices into advice for EU regulators, to achieve an appropriate balance between innovation, safety, and effectiveness. A unique collaboration between medical associations, regulatory agencies, notified bodies, academic institutions, patients’ groups, and health technology assessment agencies, will systematically review methodologies for the clinical investigation of high-risk medical devices, recommend how new trial designs can contribute, and advise on methods for aggregating real-world data from medical device registries with experience from clinical practice The consortium is led by the European Society of Cardiology and the European Federation of National Associations of Orthopaedics and Traumatology, and involves all 33 specialist medical associations that are members of the Biomedical Alliance in Europe.
