Analysing the infectious disease burden and the use of vaccines to improve healthy years in aging populations - IMI2-2017-12-05

Deadline: Oct 24, 2017  
CALL EXPIRED

Specific Challenge:

Due to the demographic situation, the older population augments in size every year. Older people are more vulnerable to infectious diseases because their immune system becomes weaker with age. The consequences are that one may observe an increasing burden of infections in the elderly with a high transmission rate. They are often treated with antibiotics causing resistance. In addition, infectious diseases are often the trigger for an underlying manifestation of chronic disease conditions those elderly are suffering. Older people need more costly treatment because of their increased frailty condition.

If infections in the elderly could be avoided, we should be able to delay, reduce, or avoid the exposure to institutionalised health care with lengthy and costly stays related to slow recovery. The situation has not been well studied with enough detail in an integrated way. Rather bits and parts have been assessed but without having a clear overall picture on how this whole process of aging, infection exposure, immune response to vaccination, is developing and potentially evolving. Therefore, before getting to a programme of vaccinating the elderly, we need to study the infection problem in greater detail. We are facing the following specific challenges in getting the full picture well presented:

1. getting access and demonstrating how to evaluate and report epidemiologic data for obtaining a clear picture on the infectious disease burden in the aged people (50 years +) (trend analysis, frequency, Quality of Life (QoL), and cost) split by specific age and gender groups, vaccine-preventable or upcoming vaccine preventable diseases, and exposure to the health care system (at home care, day care, medical care, institutional care (hospital, recovery));
2. better understanding the immune response in elderly (65 years +) by deciphering the changes taking place due to age and to other factors, the role of different facets of the immune responses, the role of new immune-modulation techniques, and to explore the potential for developing better vaccines for the elderly;
3. having disease and economic models available that predict how the current situation may further evolve without any specific intervention, and how we may project a change in disease frequency, cost and QoL of the elderly, if we implement an extended vaccination programme to reduce the burden of infections with the overall societal consequences;
4. being able to communicate an integrated view of the problem (epidemiology, cost, and QoL burden, vaccine and immunology working, economic consequences of implementing a vaccination programme among elderly) through training and education of health care professionals (HCP).

Scope:

The scope of the action is to:

• obtain a clear picture on the infectious disease burden in an aging population (50 years +);
• quantify the problem such as number and type of hospitalisations and medical visits when the 50 years + group is exposed to the health care system;
• understand this evolution over the coming years;
• obtain a better insight in the immune response in the age-group of 65 years +;
• develop cost-benefit predictions based on an extended vaccination programme;
• better control the burden in that age-group through simulations with advanced disease models, and finally;
• develop strategies to educate all stakeholders working with the elderly.

Expected Impact:

• Societal gain for healthy aging: Based on the data-collection and model simulation, a recommendation will come out on how to create an optimal vaccination strategy for the older adults. If that strategy will be implemented, an evidence-based vaccination programme for the aging adult will enhance the health condition of the elderly, make important cost offsets in health care, result in benefits in leisure time of the target group and the care-givers, reduction in production loss of care-givers, and improve the quality of care. In addition, an enhanced overall knowledge of what matters among the elderly will be an important societal gain.
• Health science development: Agreed-upon standards of analysis and reporting in the field of epidemiology and economic evaluation in people over 50 years old will have a positive impact on the results of vaccination.
• Basic research in immunology and vaccinology: It is expected that the results of the project will significantly contribute to a deeper understanding of the immune-response in aging adults. This new knowledge would not be a stand-alone acquisition, but it would instead reside within the frame of a more comprehensive body of knowledge encompassing epidemiology, environmental factors, etc. The results should help to develop better vaccines or better vaccination-schedules/programmes for the target group.
• Economic analysis: The elderly are a challenging group to assess in health economic evaluations when it comes to measuring precisely health and health gain. In the elderly the cohort of evaluation is not fixed but reduces over time because of the deaths moving into the absorbing state. Many competing causes of death and interactions between various co-morbidities do not allow a readily available valuation of expected health benefits. This project should allow to more accurately estimate health gains achieved through new interventions like vaccination and cost calculations using more appropriate techniques of modelling.
• Communication strategies: Our society is evolving very rapidly in a modern area of communication that is well established in the young generation with the social media. Having a good communication strategy in place will enhance the promotion of prevention strategies such as new vaccination programmes to reduce the burden of infections in elderly.
• Through the participation of industrial partners, in particular small and medium-sized enterprises (SMEs), an additional impact in relation to strengthening the competitiveness and industrial leadershipof Europe can be expected.
• Interaction with regulatory agencies. It is expected that some of the outcome of the project may be interesting for the regulatory bodies at international (e.g. EMA), national or regional level. For this reason, updates of the progress of the project will be provided regularly as appropriate.