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Bhatt A, Monk V, Bhatti A, Eiden AL, Hermany L, Hansen N, Connolly MP, Baxter L, Vanderslott S, Mitrovich R, Slater R. Identifying factors that can be used to assess a country's readiness to deploy a new vaccine or improve uptake of an underutilised vaccine: a scoping review. BMJ Open 2024; 14:e080370. [PMID: 38719292 PMCID: PMC11086410 DOI: 10.1136/bmjopen-2023-080370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 02/28/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES Identifying whether a country is ready to deploy a new vaccine or improve uptake of an existing vaccine requires knowledge of a diverse range of interdependent, context-specific factors. This scoping review aims to identify common themes that emerge across articles, which include tools or guidance that can be used to establish whether a country is ready to deploy a new vaccine or increase uptake of an underutilised vaccine. DESIGN Scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines. DATA SOURCES Embase, CINAHL, Cochrane Library, Google Scholar, MEDLINE, PsycINFO and Web of Science were searched for articles published until 9 September 2023. Relevant articles were also identified through expert opinion. ELIGIBILITY CRITERIA Articles published in any year or language that included tools or guidance to identify factors that influence a country's readiness to deploy a new or underutilised vaccine. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened records and performed data extraction. Findings were synthesised by conducting a thematic analysis. RESULTS 38 articles met our inclusion criteria; these documents were created using methodologies including expert review panels and Delphi surveys and varied in terms of content and context-of-use. 12 common themes were identified relevant to a country's readiness to deploy a new or underutilised vaccine. These themes were as follows: (1) legal, political and professional consensus; (2) sociocultural factors and communication; (3) policy, guidelines and regulations; (4) financing; (5) vaccine characteristics and supply logistics; (6) programme planning; (7) programme monitoring and evaluation; (8) sustainable and integrated healthcare provision; (9) safety surveillance and reporting; (10) disease burden and characteristics; (11) vaccination equity and (12) human resources and training of professionals. CONCLUSIONS This information has the potential to form the basis of a globally applicable evidence-based vaccine readiness assessment tool that can inform policy and immunisation programme decision-makers.
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Affiliation(s)
- Aomesh Bhatt
- Department of Paediatrics, University of Oxford, Oxford, UK
| | - Vaneesha Monk
- Department of Paediatrics, University of Oxford, Oxford, UK
| | | | - Amanda L Eiden
- Center for Observational and Real-World Evidence (CORE), Merck & Co Inc, North Wales, Pennsylvania, USA
| | | | | | | | - Luke Baxter
- Department of Paediatrics, University of Oxford, Oxford, UK
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Pham TH, Beck E, Postma MJ, Németh B, Ágh T, de Waure C, Salisbury DM, Nutma N, van der Schans J. Country score tool to assess readiness and guide evidence generation of immunization programs in aging adults in Europe. Front Public Health 2023; 10:1080678. [PMID: 36699900 PMCID: PMC9869118 DOI: 10.3389/fpubh.2022.1080678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/14/2022] [Indexed: 01/12/2023] Open
Abstract
Objectives Delaying of policies for immunization of aging adults, low vaccine uptake, and the lack of supportive evidence at the national level could diminish the value in health and economics of such programs. This study aims to develop a "country score tool" to assess readiness and to facilitate evidence generation for aging adult immunization programs in Europe, and examine the comprehensiveness, relevance, acceptability, and feasibility of the tool. Methods The tool was developed in two phases. First, a modified Delphi process was used to construct the tool. The process included a literature review, stakeholder consultations, and a three-round Delphi study. The Delphi panel included researchers, supra-national and national decision-makers of immunization programs recruited from five countries, using snowball sampling method. The consensus was predefined at the agreement rate of 70%. Pilot testing of the tool was conducted in the Netherlands, Germany, Serbia, and Hungary involving researchers in the field of health technology assessment. After assessing the countries' readiness, researchers evaluated four features, namely comprehensiveness, relevance, acceptability, and feasibility of the tool via an online survey that included 5-scale Likert questions. The percentages of affirmative answers including "agree" and "totally agree" choices were presented. Results The review identified 16 tools and frameworks that formed the first version of our tool with 14 items. Eight experts were involved in the Delphi panel. Through three Delphi rounds, four items were added, one was dropped, and all others were amended. The consensus was achieved on the tool with 17 items divided into decision-making and implementation parts. Each item has a guiding question, corresponding to explanations and rationales to inform assessment with readiness scores. Eight researchers completed the pilot testing. The tool was rated as comprehensive (75%), relevant (100%), acceptable (75%), and feasible (88%) by participants. Conclusion Through a thorough and transparent process, a country score tool was developed helping to identify strengths, weaknesses, and evidential requirements for decision-making and implementation of immunization programs of aging adults. The tool is relevant for different European contexts and shows good comprehensiveness, acceptability, and feasibility.
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Affiliation(s)
- Thi Hao Pham
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, Groningen, Netherlands,Asc Academics, Groningen, Netherlands,Thi Hao Pham ✉
| | - Ekkehard Beck
- Department of Vaccines Value Evidence, GlaxoSmithKline, Wavre, Belgium
| | - Maarten J. Postma
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, Groningen, Netherlands,Department of Economics, Econometrics & Finance, University of Groningen, Groningen, Netherlands,Centre of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
| | | | - Tamás Ágh
- Syreon Research Institute, Budapest, Hungary
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - David M. Salisbury
- Royal Institute International Affairs, Chatham House, London, United Kingdom
| | - Nynke Nutma
- RIVM, The Dutch National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Jurjen van der Schans
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, Groningen, Netherlands,Department of Economics, Econometrics & Finance, University of Groningen, Groningen, Netherlands,*Correspondence: Jurjen van der Schans ✉
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Calabrò GE, Boccalini S, Panatto D, Rizzo C, Di Pietro ML, Abreha FM, Ajelli M, Amicizia D, Bechini A, Giacchetta I, Lai PL, Merler S, Primieri C, Trentini F, Violi S, Bonanni P, de Waure C. The New Quadrivalent Adjuvanted Influenza Vaccine for the Italian Elderly: A Health Technology Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074166. [PMID: 35409848 PMCID: PMC8998177 DOI: 10.3390/ijerph19074166] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 12/15/2022]
Abstract
Background. The elderly, commonly defined as subjects aged ≥65 years, are among the at-risk subjects recommended for annual influenza vaccination in European countries. Currently, two new vaccines are available for this population: the MF59-adjuvanted quadrivalent influenza vaccine (aQIV) and the high-dose quadrivalent influenza vaccine (hdQIV). Their multidimensional assessment might maximize the results in terms of achievable health benefits. Therefore, we carried out a Health Technology Assessment (HTA) of the aQIV by adopting a multidisciplinary policy-oriented approach to evaluate clinical, economic, organizational, and ethical implications for the Italian elderly. Methods. A HTA was conducted in 2020 to analyze influenza burden; characteristics, efficacy, and safety of aQIV and other available vaccines for the elderly; cost-effectiveness of aQIV; and related organizational and ethical implications. Comprehensive literature reviews/analyses were performed, and a transmission model was developed in order to address the above issues. Results. In Italy, the influenza burden on the elderly is high and from 77.7% to 96.1% of influenza-related deaths occur in the elderly. All available vaccines are effective and safe; however, aQIV, such as the adjuvanted trivalent influenza vaccine (aTIV), has proved more immunogenic and effective in the elderly. From the third payer’s perspective, but also from the societal one, the use of aQIV in comparison with egg-based standard QIV (eQIV) in the elderly population is cost-effective. The appropriateness of the use of available vaccines as well as citizens’ knowledge and attitudes remain a challenge for a successful vaccination campaign. Conclusions. The results of this project provide decision-makers with important evidence on the aQIV and support with scientific evidence on the appropriate use of vaccines in the elderly.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence:
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, 50121 Florence, Italy; (S.B.); (A.B.); (P.B.)
| | - Donatella Panatto
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (D.P.); (D.A.); (P.L.L.)
| | - Caterina Rizzo
- Clinical Pathways and Epidemiology Unit-Medical Direction, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Maria Luisa Di Pietro
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Fasika Molla Abreha
- Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN 47405, USA;
| | - Daniela Amicizia
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (D.P.); (D.A.); (P.L.L.)
| | - Angela Bechini
- Department of Health Sciences, University of Florence, 50121 Florence, Italy; (S.B.); (A.B.); (P.B.)
| | - Irene Giacchetta
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (I.G.); (C.P.); (S.V.); (C.d.W.)
| | - Piero Luigi Lai
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (D.P.); (D.A.); (P.L.L.)
| | - Stefano Merler
- Center for Health Emergencies, Bruno Kessler Foundation, 38122 Trento, Italy; (S.M.); (F.T.)
| | - Chiara Primieri
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (I.G.); (C.P.); (S.V.); (C.d.W.)
| | - Filippo Trentini
- Center for Health Emergencies, Bruno Kessler Foundation, 38122 Trento, Italy; (S.M.); (F.T.)
- Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, 20136 Milan, Italy
| | - Sara Violi
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (I.G.); (C.P.); (S.V.); (C.d.W.)
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50121 Florence, Italy; (S.B.); (A.B.); (P.B.)
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (I.G.); (C.P.); (S.V.); (C.d.W.)
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