Mission & Objectives
Vaccination is a cornerstone of public health, and one of the most cost-effective interventions available. Vaccines can prevent both acute infectious diseases (e.g. measles and meningitis) and chronic diseases (e.g. liver and cervical cancer), and have greatly contributed to reducing morbidity and mortality over the last few decades, particularly among children and the elderly.
The introduction of newer strategies for vaccine development that are mainly based on genetic engineering and reverse vaccinology means that the number of available vaccines will significantly increase in the future, but there are still various open questions concerning vaccine use. It is not clear which immunisation programme can provide the longest protection, and this has led to national differences in the recommended schedules: for example, the USA and some other industrialised countries recommend priming series of several vaccines for younger children based on three doses administered at intervals of two months during the first six months of life, whereas Italy and the Scandinavian countries consider two doses to be sufficient. The patients at risk of specific vaccine-preventable diseases are frequently identified on the basis of indirect criteria that are not shared by all experts, and so the list of patients who should receive continuous vaccine protection by means of periodic booster doses of a given vaccine varies from country to country. It has not been established how frequently the booster doses of most vaccines should be given, and too little is known about the real immune response of patients with chronic diseases to the administration of standard doses of the individual vaccines. Furthermore, the vaccination coverage of patients at risk is generally very low mainly because of poor compliance with the recommendations of medical specialists.
In a number of countries, evaluations of the benefits of vaccines and the post-marketing surveillance of adverse events are inadequate. The same is true of the monitoring of changes in the circulation of the infectious agents that the individual vaccines are directed against, and this can lead to the unexpected emergence of diseases due to pathogenic strains that are not covered by the existing vaccine, as has been clearly demonstrated by the recent increase in diseases due to pneumococcal serotypes not included in the widely used pneumococcal heptavalent conjugate vaccine. Furthermore, even when available, these data are not effectively communicated, and so an opportunity to bolster advocacy and build a solid platform for trust and confidence in vaccines is missed, whereas some of the myths used by the opponents of vaccination actually need to be exposed.
The aims of the ESCMID Vaccine Study Group (EVASG) will therefore be:
- to compare immunisation schedules across countries, and collect data concerning the incidence of vaccine-preventable diseases and the sensitivity of their etiological agents to the most widely used drugs;
- to produce multicentre data concerning the immunogenicity, safety, tolerability and efficacy (if feasible) of old and new vaccines in patients with high-risk, chronic underlying diseases;
- to implement educational programmes concerning the benefits associated with vaccines and the real incidence and severity of vaccine-related adverse events;
- to prepare educational programmes for the general public aimed at counteracting negative thinking about vaccines;
- to cooperate with international organisations on multidisciplinary initiatives concerning the use of vaccines;
- to identify priorities for vaccine research and education.