Vaccine Safety- Attitudes, Training and
Communication (VACSATC)
www.vacsatc.eu
Prof. Dr. Pierre Van Damme
Ir. Alex Vorsters
Centre for the Evaluation of Vaccination
WHO Collaborating Centre for Control and Prevention of Viral
Hepatitis
Unit of Epidemiology and Social Medicine
University of Antwerp
Vaccine Safety- Attitudes, Training
and Communication (VACSATC)
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September 2006-September 2009
14 partners in 13 countries
Budget: 1.451.859 EURO
Funding:
– 60% DG SANCO
– 40% Project partners
• Coordinator
Swedish Institute for Infectious Disease Control (SMI)
Harald Heijbel, MD, MPH
FEAM Spring meeting Rome May 2007
General Objectives of VACSATC
• Identify perceptions and unmet information needs of
health consumers and health professionals
• Improve the effectiveness of vaccination programmes
through better informed and educated health consumers
and health professionals
• Provide objective science based information about
immunizations and vaccine safety on web sites to the
general public and to health professionals
• Improve possibilities for conducting epidemiological
studies on causality by studying the feasibility of
establishing large linked database systems
FEAM Spring meeting Rome May 2007
Rational/background of VACSATC
• Knowledge about attitudes to immunization
• Training of medical and paramedical personal
• Number of web sites which meet the GACVS
(the WHO Global Advisory Committee on
Vaccine Safety) good information criteria
FEAM Spring meeting Rome May 2007
Vaccine safety
concerns
Disease
incidence
The 'new' UK media environment
“Journalists aren’t employed to keep you
healthy, or even informed: it is our job to sell
readers to advertisers, to entertain you, and
experience has taught us that we can do this
very effectively with scare stories”.
(Ben Goldacre,The Guardian 16 Sept, 2003)
“Health scares such as this protect no one,
whatever the sanctimonious claims of the zealots
behind them. The MMR panic is more likely to
cause death from measles than it is to save a
single child from autism.
(Mark Henderson, The Times 20 Sept, 2003)
UK communication research
• Twice a year, a market research company
interviews 1,000 mothers of children under
3 years
• Now have 27 waves of tracking research
• Geographically representative and
represents all population groups
• Sampling can be adapted, e.g. to increase
numbers from ethnic groups if relevant
• Core questions can be adapted for new
concerns
Actual vs. Ideal source of info
about immunisation (HPs)
58%
53%
Health visitor
57%
GP / Own doctor
30%
22%
Leaflets
Practice nurse
Midwife
Immunisation
appointment card
Actual
71%
19%
18%
16%
13%
13%
25%
Ideal
‘Children are immunised against too
many diseases at one time’
% Agree
Agree
15-24
25-34
33%
32%
31%
35+
ABC1
C2DE
31%
*
41%
40%
**
41%
41%
**
42%
38%
40%
38%
43%
**
39%
38%
34% **
42%
41%
nov/05
mei/05
nov/04
Trust advice about immunisation
given by HPs and Government
60%
% Strongly Agree
50%
44%
40%
40%
37%
37%
32%
30%
44%
38%
33%
28%
31%
37%
34%
28%
39%
34%
30%
49%
GPs
42%
Health visitors
37%
Practice nurses
34%
NHS
28%
24%
20%
10%
9%
0%
Mar 03
13%
12%
May 04
Nov 04
12%
15%
10%
Oct 03
May 05
Nov 05
Government
Rational/background of VACSATC
• Knowledge about attitudes to immunization
• Training of medical and paramedical personal
• Number of web sites which meet the GACVS
(the WHO Global Advisory Committee on
Vaccine Safety) good information criteria
FEAM Spring meeting Rome May 2007
When You Think About the Last Vaccine Your Child
Received, Did Your Child get it because... :
General
Public
Subgroup
Parents
Physicians are the key drivers for childhood vaccinations
TOTAL
D
... your physician
recommended it
E
F
I
67%
84%
19%
... you asked for it
Following the
vaccination card
8%
Both (physician
and patient)
2%
Others/ Don't
know
3%
GP: Q. B4c (c); Base: n = 727 General Public Respondents/ Subgroup Parents
(weighted data: D: n = 188, E: n = 104, F: n = 163, I: n = 127, UK: n = 145)
FEAM Spring meeting Rome May 2007
UK
17%
Background cont’
According to vaccine coverage studies in
Germany, Italy and Belgium, vaccinators are the
most convincing source of information for
parents
Schmitt et al. Vaccine 2002
Bonanni et al. Vaccine 2002
Swennen et al. Vaccine 2002
FEAM Spring meeting Rome May 2007
Background cont’
• “Most nursing and medical courses in this
country, including those at postgraduate level,
provide little core training in immunisation theory
and practice, so this need has to be met through
continuous professional development whilst in
service.”
A Cummins, L Lane, D Boccia, NS Crowcroft
‘Survey of local immunisation training in England
– the case for setting national standards’
Commun Dis Public Health 2004; 7:267-71
FEAM Spring meeting Rome May 2007
Background cont’
“Finally, not all medical schools do give courses
in vaccination, and actually since there is no
“infectious diseases speciality”, the training of
German physicians is incomplete with regard to
vaccination. This may at least in part explain,
why many physicians in the country oppose
vaccination..”
Heinz-J. Schmitt ‘Factors influencing vaccine
uptake in Germany’ Vaccine 20 (2002) S2–S4
FEAM Spring meeting Rome May 2007
Rational/background of VACSATC
• Knowledge about attitudes to immunization
• Training of medical and paramedical personal
• Number of web sites which meet the GACVS
(the WHO Global Advisory Committee on
Vaccine Safety) good information criteria
FEAM Spring meeting Rome May 2007
Background –
Information on websites
• Web sites are increasingly important as a
source of information on vaccines
• Some sites present information that is not
based on science
FEAM Spring meeting Rome May 2007
WHO Vaccine Safety Net Project
• ” to develop a network of partner websites
to address unbalanced and misleading
vaccine safety information propagated on
the web”
FEAM Spring meeting Rome May 2007
GACVS criteria for good
information practices
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Essential criteria i.e. credibility
Important criteria i.e. content
Practical criteria i.e. accessibility
Desired criteria i.e. with respect to design
http//www.who.int/immunization_safety/
safety_quality/vaccine_safety_websites/en/..
FEAM Spring meeting Rome May 2007
Organisation chart VACSATC
Swedish Institute for
Infectious Disease Control
Coordinator
Steering Board:
-Department of Health, UK
-University of Antwerp, Belgium
-Institute of Public Health, Slovenia
Swedish Institute for Infectious
Disease Control
Project leader: Dr Harald Heijbel
WP 1, 2, and 3: Coordination,
Dissemination, and Evaluation,
WP4 Linkage of databases
WP7 GACVS Websites .
Department of Health, UK
University of Antwerp, Belgium
Project leader: Dr Joanne Yarwood
WP5: Attitudes to
vaccine preventable diseases,
immunizations and AEFIS
Project leader: Dr Pierre Van Damme
WP6: Improvement of pre-service
immunisation training
of health professionals
FEAM Spring meeting Rome May 2007
Project Partners :
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Swedish Institute for Infectious Disease Control, Sweden
Generaldirektion Öffentliche Gesundheit, Austria
Norwegian Inistitute of Public Health, Norway
Medical Association of Barcelona, Spain
Institute of Public Health, Romania
National Institute of Hygiene, Poland
Gazi University, Turkey
National Centre for Epidemiology, Hungry
University of Antwerp, Belgium
Sachs Children's Hospital, Sweden
Institute of Public Health, Slovenia
Universtá di Firenze, Italy
Health Protection Inspectorate, Estonia
Department of Health, United Kingdom
National Center of Infectious and Parasitic Diseases, Bulgaria
FEAM Spring meeting Rome May 2007
Objectives WP4
• To describe current status of Large Linked
Database systems with respect to:
– information
– personal identifiers
– regulations on confidentiality
– organisation
– funding
FEAM Spring meeting Rome May 2007
Participants WP4
• Coordinator: Sweden: Swedish Institute for Infectious
Disease Control, Stockholm
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Austria: FM for Health and Women, Wien
Poland: National Institute of Hygiene, Warsaw
Romania: Institute of Public Health, Bucharest
Turkey: GAZI University, Ankara
FEAM Spring meeting Rome May 2007
Objectives WP5
• To study perception of immunisation and vaccine
safety
• To collect and summarise existing studies on
public perception of vaccines and methods used
in these studies
• Develop a ‘tool-kit’ on survey methodologies
based on best practices
• Carry out and evaluate pilot and/or full-scale
surveys
FEAM Spring meeting Rome May 2007
Participants WP5
• Coordinator: United Kingdom: Immunisation Information,
Department of Health, London
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Estonia: Health Protection Inspectorate, Tallinn
Norway: Norwegian Institute of Public Health
Poland: National Institute of Hygiene, Warsaw
Romania: Institute of Public Health, Bucharest
Slovenia: Institute of Public Health, Ljubljana
Sweden: Swedish Institute for Infectious Disease
Control, Stockholm
• Turkey: GAZI University, Ankara
FEAM Spring meeting Rome May 2007
Objectives WP6
• Benchmarking of the medical and paramedical
curricula in the participating countries and report
on possible improvements of the training on
aspects of vaccines and vaccinations, including
vaccine safety and information, education and
communication to the general public.
• Provide tools to improve pre-service training of
future health personnel
• Develop criteria for good immunisation training
and tools for quality control and evaluation.
FEAM Spring meeting Rome May 2007
Participants WP6
• Coordinator: Belgium: Centre for the Evaluation of
Vaccination, University of Antwerp, Antwerp
• Bulgaria: National Centre of Infectious and Parasitic
Diseases, Sofia
• Italy: University of Florence
• Spain: Medical Association of Barcelona
• Romania: Institute of Public Health, Bucharest
• Slovenia: Institute of Public Health, Ljubljana
• Sweden: Swedish Institute for Infectious Disease Control
• Sweden: Sachs Children's Hospital, Stockholm
• Turkey: GAZI University, Ankara
FEAM Spring meeting Rome May 2007
Objectives WP 7
• Evaluate partner websites
• Develop ”best practices” for vaccine
information websites
• Development of ”repository”
• Improve web sites and evaluate against
GACVS criteria
FEAM Spring meeting Rome May 2007
Participants WP7
• Coordinator: Swedish Institute for Infectious Disease
Control, Stockholm
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Austria: FM for Health and Women, Wien
Hungary: National Centre for Epidemiology, Budapest
Norway: Norwegian Institute of Public Health
Poland: National Institute of Hygiene, Warsaw
Romania: Institute of Public Health, Bucharest
Spain: Medical Association of Barcelona
Turkey: GAZI University, Ankara
United Kingdom: Immunisation Information, Department
of Health, London
FEAM Spring meeting Rome May 2007
• Important to continue to
bridge information
exchange with other related
EU-projects and WHO Euro
FEAM Spring meeting Rome May 2007