Jim McMenamin, Chair of the I-MOVE+ Scientific-Steering Committe, published a Thought Leader in the EU Parliament Magazine stressing the importance of independent evaluation when demonstrating the effectiveness of vaccines as part of the European Immunization Week 2016. I-MOVE+ (Integrated Monitoring of Vaccines in Europe) is a consortium of 26 partners (regional and national public health Institutes, SME, Universities frrom of 15 European Union / European Economic Area Member States. Its goal is to develop a sustainable platform of primary care, hospital and laboratory networks that use validated standardised methods to evaluate existing and new vaccines programmes independently from commercial interests.
"Independent evaluation is key to ensuring public confidence in vaccines"
Public confidence in vaccines is fragile. It is often negatively impacted by ant-vaccine groups, media questioning and by perceived conflicts of interest between researchers and producers. The success of immunisation programmes against childhood and adult vaccine preventable disease has also led to a drop in concern resulting in gaps in vaccination coverage. It is important to ensure that people have confidence in vaccines by demonstrating that their effectiveness and safety evaluations are carried out independently from funding and commercial pressures. This independence is particularly important when communicating on vaccine recommendations. There are two different funding and governance models for measuring vaccine performance at EU level. One model excludes industry from funding and governance through processes such as funding through the European Commission's Research DG (the I-MOVE+ project funded through Horizon 2020 for example), or by EU agencies such as the European Centre for Prevention and Disease Control (ECDC) funding for I-MOVE, SpIDnet and PERTINENT projects. The other includes industry in the funding and governance in the context of public-private partnerships such as the Innovative Medicines Initiative-funded ADVANCE project. In the industry-independent model all four projects are funded with EU member state and Commission financial support and include 18 EU/EEA member states and 34 partners including national or regional public health and universities, with their networks of general practitioners, laboratories and hospitals. They measure vaccine-effectiveness against influenza, pneumococcal and pertussis infections as well as the impact of vaccination strategies. These projects funded with EU public money have ensured the provision of vaccine effectiveness estimates for influenza in each season as well as guiding policymaking at national, European and WHO level (WHO committee on influenza vaccine strain selection) in a timely manner.
They help in identifying new and emerging pneumococcal strains and resistance to antibiotics. They also improve our understanding of the rate and severity of infant whooping cough. During annual workshops European, Pan-American and Australian experts review each project's methodological and operational aspects. These results are then discussed with national, EU and WHO public health authorities. The performance of vaccines, need to be carefully evaluated using appropriate and independent studies. This is currently accomplished through funding from the Commission and its agencies. It needs to be extended to all vaccine preventable diseases through EU mechanisms and scientific networks that ensure rigorous science and complete scientific independence from commercial pressures. The current Commission funding stream and governance model, which are independent of the pharmaceutical industry, have allowed the development of large EU networks that could not otherwise have been possible through the use of joint public-private ventures. Furthermore, most member states do not permit public-private partnerships for national disease surveillance, evaluation of vaccine performance or for communicating on vaccine recommendations. Therefore, we believe that studies evaluating vaccine performance should be conducted independently from funding sources guaranteeing scientifically rigorous independent evaluation without jeopardising public confidence.
Alain Moren and Marta Valenciano of EpiConcept facilitated a workshop on scientific writing from 4 to 8 April as part of the Field Epidemiology Training Programme of the Indian Ocean Commission (FETP-COI).
The workshop was given to nine interns of the cohorte 3 of FETP-COI. The facilitator's team consisted of EpiConcept's two epidemiologists, two epidemiologists from the Health Surveillance Unit of the COI and the coordinator of the FETP-COI (Field Epidemiology Training Programme of the Indian Ocean Commission).
Using the "e-SIS" digital X-ray reading, storage and transmission system, the Drôme-Ardeche cancer prevention organisation is now able to inform patients of their mammography results within 72 hours as opposed to 15 or more days before the system was used. Because the Drome has a fiber optic Internet connection, the interest of three radiology centers, and the financial support of the department (100K€), it was the ideal area for deployment of the system. The objective for Etienne Paré, the center's director, is to get the e-SIS system into all of the department's radiology centers and in the future extend it to other types of screening programmes.
The e-SIS consortium is composed of four entities: EpiConcept; The CDI company (responsible for setting up the Swiss federation’s cancer screening information system) whose IT system has managed a 100% digital workflow for the past five years; the Fribourg engineering school (for the R&D); SESAM, a Turkish company specialised in IT systems integration.
This project is made possible through investments by each of the parties involved and through a financing programme for innovation by EUROSTARS from the European Commission. The piece of the information system developed by EpiConcept is based on Voozanoo.
The public hospital network of Paris will soon be using a Voozanoo based application for its infectiology hotline response teams. Available 24/7, the infectiology response phone line will use the application to log the incoming information from emergency units, intensive care units, and “SOS Doctors” as well as the prescribed action and location of nearest treatment centre if needed. This web application is based on the Voozanoo application framework certified by the ministry of health for “Personal health data hosting”. The information system was put into production in mi March.
Amman Jordan was the host site for the 4th NOMAD (Humanitarian Operations Mobile Acquisition of Data) conference on January 27 and 28 which brought together NGOs and private sector providers of mobile data collection tools. EpiConcept presented the specifications for its upcoming native Android and iOS tablet and smart-phone applications which work together with Voozanoo based applications and include not only data collection, but feedback and task management to the aid worker. The choice of Jordan as the conference site was made to facilitate the attendance of front-line aid workers who operate in this region. Included were discussion sessions on best practices in deploying mobile data collection tools and the presentation of case studies. In addition to the native smartphone application, EpiConcept also presented its free data collection tool Wepi (works with ODK - Open Data Kit Collect, a well known Android application) which was appreciated for its native support of right to left Arabic texts. The conference included a little over 100 individuals representing some forty aid agencies and was sponsored by the UNHCR (United Nations High Commission for Refugees).
As part of the 3rd steering committee for the Indian Ocean Commission’s (IOC) health surveillance programme which met on the 11th and 12th of February in the Seychelles, a workshop was held to discuss the preparedness of the region’s response to a Zika virus outbreak were it to happen. The steering committee was able to set down structural plans allowing greater cooperation among the health organisations of the region in order to meet the challenges of such disease outbreaks. Dr. Loïc Flachet, director of the SEGA One Health network, Dr. Alain Moren and Guillaume Jeannerod represented EpiConcept at this meeting. EpiConcept provides support for the work of the IOC’s health surveillance unit.
The Eurosurveillance journal has published the results of a European multicentre study measuring the 2014/15 seasonal influenza vaccine effectiveness against laboratory confirmed-influenza. This multicentre study is one of the components of the I-MOVE network and includes data from Germany, Ireland, Poland, Hungry, Portugal, Italy, Romania and Spain. Since 2008 the I-MOVE network has measured the effectiveness of seasonal influenza vaccines and, in 2009, the effectiveness of the pandemic vaccine. The study is coordinated by EpiConcept in collaboration with the participating sites’ epidemiologists and the ECDC (European Centre for Disease prevention and Control). Marta Valenciano and Esther Kissling are the principal investigators for this study. They stated that, “In Europe, during the 2014/15 season, three flu viruses were circulating: B, A(H1N1) pdm09 and influenza A (H3N2). This case-control study was able to provide influenza vaccine effectiveness estimates against each of the three viruses. We were able to measure the effectiveness by vaccine type and by age group”.
EpiConcept has published the I-MOVE multicentre case-control study early estimates of the effectiveness of the 2015-16 influenza vaccine. These results are shared with the WHO vaccine strain selection committee that will meet 22-24 February 2016 to define the composition of the 2016-17 northern hemisphere influenza vaccine. The I-MOVE network has been coordinated by EpiConcept since 2007. See more information about the interim results.
In December 2015, EpiConcept was entrusted with an expertise mission sponsored by the WHO (World Health Organisation) to create a protocol for evaluating the direct and indirect effects of the pneumococcal conjugate vaccine (PCV) andthe anti-rotavirus vaccine for the Morrocan ministry of health. This mission has engaged the services of three epidemiologists from EpiConcept’s epidemiology department. The mission is planned to conclude this month.
The centres for free and anonymous HIV screening (CDAG) and for information, screening and diagnostics of STDs (CIDDIST) from the Melun Hospital centre, Meulan-les-Mureaux hospital center, the French Red Cross of Paris, Toulouse university hospital centre, and the Paris social, children, and health action directorate have migrated to the new version of EpiConcept's CUPIDON information system as part of their accreditation to Free Centres for Screening and Diagnostics (CeGIDD). These centers now benefit from all the new functionalities specifically put in place for the CeGIDD centres.
The Toulon university hospital centre has chosen EpiConcept’s Cupidon web application as its IT solution for anonymous screening and diagnosis of sexually transmitted infections (CeGIDD). The solution allows the centre to manage all the consultations from the initial intake to the delivery of the results. The system will also automatically create quarterly activity results for the center and allow the user to consult an activity dashboard. This simple solution which is adapted to the screening center’s activities is an on-line web application made possible by EpiConcept’s ministry of health certification as a “Personal health data hosting provider”.
Esther Kissling - Influenza vaccine effectiveness (VE) estimates from the I-MOVE multicentre case control study in Europe, 2014-15: low vaccine effectiveness against A(H3N2) and moderate vaccine effectiveness against A(H1N1)pdm09 and B
Germaine Hanquet - Indirect effect of childhood PCV10/13 vaccination on invasive pneumococcal disease among seniors 65 years old and over in six European countries (Spidnet network): Implications for PCV13 vaccination of the elderly
IOC - Alain RAKOTOARISOA - Bubonic plague outbreak investigation in the endemic district of Tsiroanomandidy - Madagascar, October 2014 (also presented in Mexico City at the 8th TEPHINET Global Conference 7-11 September 2015)
IOC - Lala Harisoa Rabetaliana - Pneumonic plague outbreak following case migration from the endemic highlands – municipality of Ambaohoabe, Madagascar, December 2013
Marc Rondy - High and rapid effectiveness of polysaccharide vaccines against clinical meningitis in Niger, 2015.
IOC- Rado Randriamiarana - Evaluation of the reinforced Integrated Disease Surveillance and Response strategy using short message service data transmission in two southern regions of Madagascar, 2014-5. Presented by Ariane Halm.
IOC -Mireille Randria - One year of sentinel surveillance of malaria and severe acute respiratory hospitalisations and deaths in Madagascar, September 2014 - August 2015. Presented by Alain Rakotoarisoa.
IOC - Mireille Randria - Worrying resurgence of severe malaria in non-endemic area: Case of the hospital of Fianarantsoa, from October 2014 to May 2015, Madagascar. Presented by Alain Rakotoarisoa.
IOC - Harimahefa Razafimandimby - Household and behavioural risk factors for human plague in Madagascar, 2012-3. Presented by Lala Harisoa Rabetaliana.
IOC - Ariane Halm - Four years of regional field epidemiology training programme in the Indian Ocean
EpiConcept is collaborating with the Moroccan ministry of health in enhancing the surveillance systems for rotavirus and invasive pneumococcal infections for evaluating the effectiveness and impact of the related vaccines between December 2014 and January 2016.
The CDHS (Departmental Committee for social hygiene) has entrusted EpiConcept with the design and implementation of its electronic health records system for its six health centres in the Rhône department. The software is designed to optimize and facilitate the treatment plan, making appointments, waiting lists and the production of statistical reports. Centered around an individual patient, it covers vaccination, pulmonology, smoking issues, social aspects and the management of inquiries into tuberculosis cases (DAMOC). Based on EpiConcept’s Voozanoo plateform, it benefits from the Ministry of Health’s certification for hosting personal health data. The application has been in use since October 2015.
On the 26th and 27th of October, the Indian Ocean Commission (IOC) held its third scientific conference on the SEGA ONE HEALTH project. This programme’s goal is to reinforce surveillance, alerts, investigations and epidemic event responses. EpiConcept provides support for the work of the IOC’s health surveillance unit.
As part of the the Indian Ocean Commission’s (IOC) Field Epidemiology Training Programme (FETP), EpiConcept taught a one-week course in scientific communications. The trainees learned methods for both written and oral delivery. The course was held on the last week of September in the capital Antananarivo.
The French ministry of health has renewed the ASIP certification of EpiConcept’s Voozanoo information system platform for hosting applications containing personal health data for another three years. The ASIP certification was initially attributed to the Voozanoo development platform in May of 2012 and is renewable every three years based upon a positive evaluation result. ASIP is the public interest group which manages the certification process for Personal health data hosting providers.
Phare is a software application to register and follow up patients with a hereditary risk to cancer and to manage their personalised treatment plan. Phare is based on Voozanoo which allows each region to adapt the patient filing system to their particular practices while keeping the standard functions; management of of the personalised treatment plan, exam planning and follow-up, and postal mailings and reminder mails. The Phare application is being deployed by the “Proche” (regional prevention of hereditary cancer) network who manages patient follow-up in the Nord-Pas-de-Calais region. Currently there are 1600 patients in the network with 400 new patients added each year.
As part of the Cytomegalovirus (CMV) epidemiological surveillance effort in France, the National Reference Center for CMV has chosen EpiConcept’s Voozanoo platform to collect infection declaration questionnaires :
- Declaring infections and suspected infections in pregnant women and newborns - Monitoring children with congenital infections or those acquired over 10 years
The National Reference Center teams were trained to use Voozanoo and can thus manage the declaration and follow-up questionnaire updates. The center can also put in place ad hoc questionnaires as needed.
The goal of this project is to create a patient follow-up system for the 25 expert centers in the French national clinical research network on Parkinson’s disease (NS-Park, FCRIN). The application will be used as a centralised information system for medical personnel to bring together all information from among the various practitioners (Neurologists, surgeons, neuropsychologists, dieticians, chiropractors, etc.). The creation of a common patient dossier for multiple centers will simplify follow-up for patients who move. The information system will automatically create each centre’s annual activity report for the regional health agency (ARS). As well, it will allow for patient selection (among those who consent to it) for various clinical research studies. In whole, a database to be used for research on Parkinson’s disease. Using EpiConcept’s Voozanoo 4 as the technology platform for this will enable multi-format (tablet, netbook or computer) use depending on the equipment of each centre. More information can be found at www.parkinson.network.