I-MOVE+: éditorial sur l'indépendance de la recherche scientifique dans l'évaluation des vaccins
Jim McMenamin, à la tête du comité de pilotage du projet I-MOVE+, a écrit un editorial dans le EU Parliament Magazine soulignant l'importance de l'évaluation indépendante des vaccins dans la démonstration de leur efficacité à l'occasion de la Semaine Européenne de la vaccination 2016.
I-MOVE + (surveillance intégrée des vaccins en Europe) est un consortium de 24 partenaires (instituts de santé publique régionaux et nationaux, petites et moyennes entreprises et universités) de 17 États membres de Union Européenne et de l'Espace Economique Européen. Son objectif est de développer une plate-forme durable de réseaux de soins primaires, d'hôpitaux et de laboratoires qui utilisent des méthodes standardisées validées pour évaluer des programmes vaccinaux, nouveaux ou existants, indépendamment des intérêts commerciaux. I-move + a reçu une subvention de trois ans (mai 2015 - mai 2018) de la Commission européenne (H2020) pour identifier, piloter, mettre en oeuvre, et diffuser les meilleures schémas d'étude pour mesurer, l'efficacité et l'impact des vaccins utilisés chez les personnes âgée pour prévenir la grippe et les infections à pneumocoque. I-MOVE + est organisé en cinq lots thématiques sous la coordination d’EpiConcept (www.i-moveplus.eu).
"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.
(First published in the EU Parliament Magazine)
I-MOVE+ has received a grant (May 2015- Oct 2018) from the European Commission (H2020) to identify, pilot test, use, and disseminate the best study designs to measure, in near real time the effectiveness and impact of vaccines used in the elderly population to prevent influenza and pneumococcal infections.