Thursday 25 April – the EUVABECO (European Vaccination Beyond COVID-19) initiative is advancing with the introduction of five innovative tools, including a key Clinical Decision Support (CDS) system, aimed at enhancing the vaccination experience and increasing the efficiency of vaccination programs. Building on the success of a system previously deployed in France and Luxembourg, EUVABECO will initiate pilot programs in Latvia, Belgium, Greece, Poland, and Portugal. The CDS system taps into vast datasets to provide vaccination advice tailored to the specific health profiles of individuals. This empowers patients with personalized vaccination information and supports healthcare providers in making informed vaccine administration decisions. By enhancing access to detailed, up-to-date information, CDS have the potential to build confidence in vaccination.
How and why will EUVABECO work with partners to deploy a Clinical Decision System for vaccination?
A one-size-fits-all approach to vaccination, though straightforward, overlooks the unique needs of individuals. The risk of exposure to infectious diseases and the severity of the potential disease vary greatly among people. It is therefore crucial for vaccination programs to target those who will benefit the most, whether they are the vaccine recipients themselves, or members of their community. For example, the bacille Calmette–Guérin (BCG) vaccine for tuberculosis, previously universally administered across Europe [1], is now primarily recommended for children up to 6 years old who are at an increased risk of TB infection [2].
This concept of customization finds a parallel in World War II when the United States Air Force undertook a project to design an “average” cockpit based on measurements from thousands of pilots. Despite comprehensive planning, the project encountered setbacks as most pilots did not fit the “average” mold, leading to the innovative solution of adjustable seats. This adaptation allowed cockpits to accommodate pilots of various sizes, highlighting the importance of an individualised approach [3].
The EUVABECO initiative embodies this adaptive philosophy in healthcare by introducing a Clinical Decision Support (CDS) system. Vaccination CDS are designed to navigate the complex landscape of vaccine decision-making, integrating scientific evidence, health considerations, and diverse guidelines to tailor vaccine recommendations to individual health profiles.
CDS synthesize data from a broad spectrum of sources, including electronic vaccination cards, international patient summaries, historical and electronic health records, local vaccination guidelines, and direct patient feedback through questionnaires [4]. This integration allows for an exhaustive evaluation of factors like demographics, living conditions, employment status, medical and vaccination history, family situations such as the arrival of a newborn, chronic conditions, and serological test results, ensuring the CDS offers guidance that is both accurate and personalised.
In France, the perceived value of the CDS to the health workforce has been particularly apparent in recent months, as many pharmacists, who were recently authorized to prescribe and administer vaccines [5], have quickly adopted a CDS tool [6]. Assistant Pharmacist Sophie Bender noted that these tools “motivate patients to get vaccinated, especially for often overlooked vaccines like Meningococcal C”. Meanwhile, Pharmacist Anne Andraud highlighted that the CDS “provides reliable, personalized vaccination information, enhancing our advisory role and facilitating meaningful interactions with patients, which is crucial today” [7].
EUVABECO’s partner organizations in Latvia (Riga Stradiņš University), Belgium (Fratem), Greece (University of Thessaly), Poland (Jagiellonian University), and Portugal (Directorate-General of Health) are now set to work closely with EUVABECO’s CDS specialists to adjust a CDS system of their choice to their specific local context. This will include translating vaccination guidelines, customizing the system for local healthcare settings, crafting justification messages and questionnaire items, and conducting pilot tests to ensure the system’s recommendations are accurate and reliable.
Considering the diverse healthcare environments in these countries, including differences in epidemiological trends, immunization information systems, vaccine nomenclature, and collaboration dynamics with National Immunization Technical Advisory Groups (NITAGs), EUVABECO is dedicated to crafting and assessing implementation plans that are effective, adaptable, and sustainable in various healthcare landscapes. The ultimate goal is to disseminate these rigorously tested implementation plans to all EU Member States, enabling a wider uptake of vaccination CDS. These comprehensive plans will include detailed workplans, policy recommendations, strategies for outbreak response, criteria for assessing the system’s impact, and financial considerations for its implementation.
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References
[1] Dara et al. (2014). Bacille Calmette–Guérin vaccination: the current situation in Europe. European Respiratory Journal 2014 43: 24-35 [publication] (https://erj.ersjournals.com/content/43/1/24#:~:text=During%20the%20first%20half%20of,specifically%20in%20tuberculosis%2Dendemic%20areas, accessed April 3 2024).
[2] European Centre for Disease Prevention and Control. Vaccine Scheduler. Tuberculosis: Recommended vaccinations [web portal] (https://vaccine-schedule.ecdc.europa.eu/Scheduler/ByDisease?SelectedDiseaseId=14&SelectedCountryIdByDisease=-1#:~:text=BCG%20vaccination%20is%20recommended%20for,planned%20longer%20(more%20than%20three, accessed April 3 2024).
[3] Daniels, G. (1952). The “Average Man”. Wright Air Development Centre. DOI: 10.21236/AD0010203 (https://scholar.archive.org/work/bpknco4mhfcjbhesnjt2me4dea, accessed April 3 2024).
[4] MesVaccins. Vaccine Recommendations [web portal] (https://mentor.mesvaccins.net/en-gb, accessed April 3 2024)
[5] République française. Service-public.fr. Le site officiel de l’administation française [web portal] (https://www.service-public.fr/particuliers/actualites/A16732?lang=en, accessed April 3 2024)
[6] MesVaccins subscription data (personal communication)
[7] Personal communication with Francois Kaag (Syadem) and Jean-Louis Koeck (Syadem)
