Periodic Reporting for period 5 - VITAL (Vaccines and Infectious Diseases in the Ageing PopuLation)
Okres sprawozdawczy: 2023-01-01 do 2023-12-31
One of today’s major challenges in infectious diseases (ID) management is improving efficacy of vaccines and efficiency of prevention in the growing ageing population. The VITAL project aims to address this challenge by (1) assessing the ID burden, (2) identifying the mechanisms of decline of immune responses with age, (3) developing methods to evaluate the most efficient prevention strategies against ID, and (4) efficiently communicating the findings to healthcare professionals (HCPs) as well as to ageing adults to increase the impact of future interventions.
In WP1, we investigated the vaccine-preventable disease burden in ageing adults in two pilot regions. The interim report includes the preliminary results for Valencia and Denmark and a comparison on the incidence of Pneumonia between the two study sites. In addition a prospective multisite, multi-country longitudinal case control study was carried out in France, Germany, Italy and Spain to investigate the impact of acute respiratory infections (ARI) and/or bacteremia on the Quality of life in hospitalized patients >60 years of age. Patient enrollment finished with a total of 2056 patients; of which 637 ARI cases, 243 bacteremia cases, and 1170 controls. An immunosenescence statistical model is under development, using Influenza Like Illness data from multiple seasons in older adults.
In WP2, a clinical vaccine study was executed to understand the mechanisms underlying vaccine response in different age groups. Antibody data analysis of 326 healthy volunteers against 3 vaccines across 3 age groups revealed lower antibody concentrations in older adults following primary Pneumococcal and SARS-CoV2 mRNA vaccination compared to young adults. A shorter persistence of humoral responses towards the 6 months timepoint was observed in older adults for all vaccines. A small group of mostly older male adults responded low to multiple vaccines. T-cell responses after vaccination showed age-related differences in the percentage of donors with a detectable increase in influenza-specific T cells at day 7. Real time cell subset analyses led to the identification of 9 distinct cell subset clusters which were tested for association with influenza-specific as well as the antibody response to 3 vaccines. Specific cell subset clusters were identified that associate with poor or good response to vaccination.
Within WP3, we made the inventory of different blocks of critical information related to economic models available, heterogeneity of the target population, identification of hot spots of infected aging adults and specific preventative interventions. Next, we focused on a integrated gap-analysis to identify the precise approach to take in the development of our economic assessment. We (1) produced the gap-report, (2) started with collecting workable models on infectious diseases in ageing adults, and (3) made a critical evaluation on how our models should be developed. In year 3 we initiated the development of static, and dynamic compartment models. Year 4 focused on building a country scoring tool with which the prevention implementation can be measured. Year 5 focused on the development of the age-structured model.
After obtaining important insights on the perspective of older adults on vaccination, WP4 was dedicated to understanding the perspective of the healthcare professionals (HCP). Data collection of the in-depth interview study of HCP in the four study countries (France, Italy, Hungary and the Netherlands) was finished. Furthermore, we collected data for the questionnaire study amongst HCP. In addition, WP4 undertook a questionnaire study to visualize the networks of HCP involved with elderly. We conducted workshops with HCPs and older adult representatives in the 4 countries to identify and select appropriate training and education interventions. We defined a baseline of requirements for the intended educational platform regarding format, content, development, and implementation, to improve understanding and communication on vaccinations for older adults from a European perspective. A start was made with the development of the contents of the educational platform.
In line with the WP4 objectives and overarching strategy of the VITAL, we have progressed an active plan for external stakeholders’ engagement.
In WP2, a clinical vaccine study was executed to understand the mechanisms underlying vaccine response in different age groups. Antibody data analysis of 326 healthy volunteers against 3 vaccines across 3 age groups revealed lower antibody concentrations in older adults following primary Pneumococcal and SARS-CoV2 mRNA vaccination compared to young adults. A shorter persistence of humoral responses towards the 6 months timepoint was observed in older adults for all vaccines. A small group of mostly older male adults responded low to multiple vaccines. T-cell responses after vaccination showed age-related differences in the percentage of donors with a detectable increase in influenza-specific T cells at day 7. Real time cell subset analyses led to the identification of 9 distinct cell subset clusters which were tested for association with influenza-specific as well as the antibody response to 3 vaccines. Specific cell subset clusters were identified that associate with poor or good response to vaccination.
Within WP3, we made the inventory of different blocks of critical information related to economic models available, heterogeneity of the target population, identification of hot spots of infected aging adults and specific preventative interventions. Next, we focused on a integrated gap-analysis to identify the precise approach to take in the development of our economic assessment. We (1) produced the gap-report, (2) started with collecting workable models on infectious diseases in ageing adults, and (3) made a critical evaluation on how our models should be developed. In year 3 we initiated the development of static, and dynamic compartment models. Year 4 focused on building a country scoring tool with which the prevention implementation can be measured. Year 5 focused on the development of the age-structured model.
After obtaining important insights on the perspective of older adults on vaccination, WP4 was dedicated to understanding the perspective of the healthcare professionals (HCP). Data collection of the in-depth interview study of HCP in the four study countries (France, Italy, Hungary and the Netherlands) was finished. Furthermore, we collected data for the questionnaire study amongst HCP. In addition, WP4 undertook a questionnaire study to visualize the networks of HCP involved with elderly. We conducted workshops with HCPs and older adult representatives in the 4 countries to identify and select appropriate training and education interventions. We defined a baseline of requirements for the intended educational platform regarding format, content, development, and implementation, to improve understanding and communication on vaccinations for older adults from a European perspective. A start was made with the development of the contents of the educational platform.
In line with the WP4 objectives and overarching strategy of the VITAL, we have progressed an active plan for external stakeholders’ engagement.
In the frame of WP1 , an online catalogue available for consultation was developed, allowing an easy and fast view of existing data sources for specific ID known for their high disease burden in ageing adults. This could become a critical source of medical data able to predict the increase in ID burden over time related to the demographic shifts and an interesting tool in preclinical drug development. The protocols developed in WP1 could serve for extrapolation to burden of disease evaluations in other EU regions. By the end of the project, a public database integrated into VITAL website will showcase results from WP1 which may support collaboration for future research. This willinform allocation of healthcare resources, guide clinical decision-making, and shape public health policies aimed at improving the management and prevention of infectious diseases among the elderly.
WP2 has set up a valuable biobank and dataset for current and future studies on immunological mechanisms of vaccine responses. This can be used to support system vaccinology approaches and identify correlates of protection. Novel antibody clustering methods identified the highest risk group in the cohort to be older male participants. Cluster analysis of cell subsets and a novel metric for immune perturbation may aid the prediction and identification of individuals with lower vaccine response.
WP3 aims to address gaps in health economic evaluation related to the prevention of infectious diseases in aging adults. These gaps include challenges in decision models, intervention strategies, input data availability, and the heterogeneity of factors considered in economic evaluations. Expected impacts include improved understanding of infection spread dynamics through data collection, better consideration of quality of life impacts on older adults, enhanced economic evaluation methodologies, development of a country readiness assessment tool for vaccination strategies, and prioritization of preventive measures within healthcare budgets. It will be a big incentive for decision makers to improve control of the spread of infection in ageing adults through a well-developed and cost-efficient prevention program.
In WP4 , a common vision for the educational framework was formed. The goal of the platform is to serve as a ‘GPS platform’ to guide users through information sources that already exist. The platform will provide an overview of reliable webpages on subjects of infectious diseases and vaccines and the underexplored subject of vaccine communication and education, an oversight of the VITAL activities related to education of healthcare professionals on communicating vaccines with older adults and a list of relevant courses on issues related to vaccine communication for older adults.
The work done on stakeholder involvement in WP4 allowed a credible and insightful information package on VITAL that can serve to craft the key messages to connect and create a dialogue with external stakeholders.
WP2 has set up a valuable biobank and dataset for current and future studies on immunological mechanisms of vaccine responses. This can be used to support system vaccinology approaches and identify correlates of protection. Novel antibody clustering methods identified the highest risk group in the cohort to be older male participants. Cluster analysis of cell subsets and a novel metric for immune perturbation may aid the prediction and identification of individuals with lower vaccine response.
WP3 aims to address gaps in health economic evaluation related to the prevention of infectious diseases in aging adults. These gaps include challenges in decision models, intervention strategies, input data availability, and the heterogeneity of factors considered in economic evaluations. Expected impacts include improved understanding of infection spread dynamics through data collection, better consideration of quality of life impacts on older adults, enhanced economic evaluation methodologies, development of a country readiness assessment tool for vaccination strategies, and prioritization of preventive measures within healthcare budgets. It will be a big incentive for decision makers to improve control of the spread of infection in ageing adults through a well-developed and cost-efficient prevention program.
In WP4 , a common vision for the educational framework was formed. The goal of the platform is to serve as a ‘GPS platform’ to guide users through information sources that already exist. The platform will provide an overview of reliable webpages on subjects of infectious diseases and vaccines and the underexplored subject of vaccine communication and education, an oversight of the VITAL activities related to education of healthcare professionals on communicating vaccines with older adults and a list of relevant courses on issues related to vaccine communication for older adults.
The work done on stakeholder involvement in WP4 allowed a credible and insightful information package on VITAL that can serve to craft the key messages to connect and create a dialogue with external stakeholders.