Commission s work on childhood immunisation

Transcription

1 Commission s work on childhood immunisation Dr Antoon Gijsens Unit C3 - Health Threats Directorate C - Public Health and Risk Assessment Directorate-General for Health & Consumers Luxembourg, ASEF meeting 1

2 Overview Commission s work on childhood immunisation Background (the issue, the causes and the results) Commission s initiative on childhood immunisation - objectives Luxembourg, ASEF meeting 2

3 immunisation background: the issue (1) Too many children in the EU are put at risk of developing severe complications from catching vaccine preventable diseases due to: Incomplete vaccination courses Not being vaccinated at all Luxembourg, ASEF meeting 3

4 immunisation background: the issue (2) Vaccination coverage in 2008 for common childhood vaccines MCV1, MCV2: 1st & 2nd dose of measles containing vaccine DTP3, Pol3, Hib3, HepB: 3rd dose of diphtheria / tetanus / pertussis vaccine, of polio vaccine, of Heamophilus influenzae type b vaccine and of Hepatitis B vaccine (*) Vaccine given to risk groups only Source: WHO vaccination coverage data 2008 MCV1 MCV2 DTP3 Pol3 Hib3 HepB3 Austria Belgium Bulgaria no data 96 Cyprus Czech Rep Denmark (*) Estonia Finland 97 no data (*) France 87 no data Germany Greece Hungary no data Ireland 89 no data no data Italy 91 no data Latvia Lithuania Luxembourg 96 no data Malta Netherlands (*) Poland Portugal Romania no data 99 Slovakia Slovenia Spain Sweden UK (*) Luxembourg, ASEF meeting

5 immunisation background: the causes (1) Vaccination coverage can be compromised by a number of factors: Absence of / issues with operational immunisation programmes Lack of advocacy to healthcare professionals and/or the public Luxembourg, ASEF meeting 5

6 immunisation background: the causes (2) Alleged serious adverse events following immunisation Influence from vaccine sceptics and opponents Luxembourg, ASEF meeting 6

7 immunisation background: the causes (3) Hard-to-reach groups with limited access to healthcare Difficulties in bridging immunisation schedules for ~100,000 children (0-1y) migrating between MS every year. Diversity in terms of: target disease target populations products used schedules and vaccine co-administration mandatory or voluntary vaccination Luxembourg, ASEF meeting 7

8 Measles mumps rubella schedules Months Years Austria 1&2 Belgium 1 2 Bulgaria 1 2 Cyprus 1 2 Czech Rep 1 2 Denmark 1 2 Estonia 1 2 Finland 1 2 France 1 2 Germany 1 2 Greece 1 2 Hungary 1 2 Ireland 1 2 Italy 1 2 Latvia 1 2 Lithuania 1 2 Luxembourg 1 2 Malta 1 2 Netherlands 1 2 Poland 1 2 Portugal 1 2 Romania 1 2 Slovak Rep 1 2 Slovenia 1 2 Spain 1 2 Sweden 1 2 UK 1 2 Source: VENICE / EUVAC.NET Luxembourg, ASEF meeting 8

9 Diphtheria, tetanus, pertussis schedules Months Years Austria (ap) Belgium (ap) Bulgaria (wp) Cyprus (wp+ap) Czech Rep (wp) Denmark (ap) Estonia (wp) Finland (ap) France (ap) Germany (ap) Greece (ap) Hungary (ap) Ireland (ap) Italy (ap) Latvia (ap) Lithuania (ap) Luxembourg (ap) Malta (wp+ap) Netherlands (ap) Poland (wp) Portugal (ap) Romania (wp) Slovak Rep (wp) Slovenia (ap) (-ap) 6 (-ap -D) Spain (ap) Sweden (ap) UK (ap) (-ap) Source: VENICE / EUVAC.NET Luxembourg, ASEF meeting 9

10 polio schedules Months Years Austria (IPV) Belgium (IPV) Bulgaria (OPV) Cyprus (IPV+OPV) Czech Rep (OPV) 1&2 3& 5 Denmark (IPV) Estonia (OPV) Finland (IPV) France (IPV) Germany (IPV) Greece (IPV+OPV) Hungary (IPV) Ireland (IPV) Italy (IPV) Latvia (IPV+OPV) Lithuania (IPV+OPV) Luxembourg (IPV) Malta (IPV+OPV) Netherlands (IPV) Poland (IPV+OPV) Portugal (IPV) Romania (OPV) Slovak Rep (IPV) Slovenia (IPV) Spain (IPV) Sweden (IPV) UK (IPV) Source: VENICE / EUVAC.NET Luxembourg, ASEF meeting 10

11 immunisation background: the results (1) Insufficient vaccination coverage results in unnecessary high disease incidence: Measles, Mumps, Rubella (MMR): major improvements needed to reach the WHO Euro goal to eliminate measles and rubella! Measles: 2,800 cases in the EU in 2007 (already >13,000 cases in 2010 due to large outbreak in Roma population!) Mumps: 1,05 cases in the EU in 2007 Rubella: 3,965 cases in the EU in 2007 Luxembourg, ASEF meeting 11

12 immunisation background: the results (2) Diphtheria, Tetanus, Pertussis: pertussis still problematic; shift to young children/adolescents/young adults (booster doses needed) Diphtheria: 21 cases in the EU in 2007 Tetanus: 125 cases in the EU in 2007 Pertussis: 12,953 cases in the EU in 2007 Luxembourg, ASEF meeting 12

13 immunisation background: the results (3) Polio: polio is eliminated in Europe but risk of imported cases if vaccination coverage doesn t remain high! 0 cases in the EU in 2007 Hib: incidence has fallen remarkably since vaccination was introduced in most MS (since 2008, universal Hib vaccination in all MS) 1,967 cases in the EU in 2007 Hepatitis B: perinatal infections (targeted screening for HBsAg positive mothers does not catch all cases) and early childhood infections (close contact) No data on case load in babies/infants/young children Luxembourg, ASEF meeting 13

14 immunisation Commission s initiative (1) Initiative to strengthen childhood immunisation in the EU. The objectives are twofold: 1. To seek a firm political commitment from Member States to step up efforts at increasing and maintaining a very high childhood vaccination coverage for priority diseases measles, mumps, rubella diphtheria, tetanus, pertussis Polio Haemophilus influenzae serotype b (Hib) hepatitis B Luxembourg, ASEF meeting 1

15 immunisation Commission s initiative (2) 2. To provide evidence-based recommendations to address the main causes of insufficient vaccination coverage: organisational issues with vaccination programmes lack of advocacy and communication alleged serious adverse events activities by vaccine sceptics/opponents groups presence of hard-to-reach groups among the population difficulties in bridging national immunization schedules Luxembourg, ASEF meeting 15

16 immunisation Commission s initiative (3) The Commission is developing a so-called impact assessment to identify the most appropriate tool Scientific guidance Council Recommendation Commission Decision under Decision 2119/98/EC Directive (?) Luxembourg, ASEF meeting 16

17 immunisation Commission s initiative () Stakeholder consultation was held in Q2 2009: public health authorities associations of general practitioners associations of paediatricians academia association of European vaccine manufacturers Timeline: Commission proposal by Q Luxembourg, ASEF meeting 17

18 Thank you for your attention! Commission web page on immunisation: ECDC web page on immunisation : mme_on_vaccine_preventable_diseases_and_invasive_bacterial_infections.aspx Luxembourg, ASEF meeting 18