Interview with Prof. Rutger Jan van der Gaag, Vice President, Standing Committee of European Doctors (CPME)
SD: Do you believe that the data provided by the vaccine registries could help in addressing vaccine hesitancy?
RG: Vaccine registries can help provide valuable data to get an accurate benchmark. This will be helpful in giving feedback and providing useful information on where some actions are needed in order to enhance the vaccination coverage in different countries, hopefully to above 90%. Yet, their usefulness should not be overestimated: there is a reasonable question about the required investment and the return on it. In other words – will the time and efforts needed to update vaccine registries be rewarded with a substantial increase of the vaccination rates. I am not quite sure about this, as the countries which have a sufficient to high vaccination rate will already have registries. On the other hand, those countries that have real vaccination coverage issues will be confronted with more problems and might just not have the means and people to ensure maintenance of the registries. Instead, they may want to consider doing other things to improve the vaccination rates. Rather than putting a lot of effort in administrative activities, they may need that personnel for other investments in trying to solve the problem.
SD: What is the single most important advice you would give medical students on vaccination?
RG: The history, benefits and problems around vaccination adherence should be part of each medical curriculum during the study, but certainly also at the end of the curriculum, when students are about to start working in the community.
SD: You mentioned that “It isn’t ignorance that does the harm, it is knowing things that are not true” – how can ‘true’ information be presented better?
RG: My concern is that at this stage, many medical doctors and some health authorities are hesitant to respond to the utter nonsense that is conveyed by anti-vaxxers. especially on the internet. By not addressing these false beliefs and speaking up against them, we are not taking sufficient action to contradict them strongly. The medical corps and health authorities neglect their mission to repeat the convincing message that vaccination has helped eradicate 14 well-known common infectious diseases, and that the risks of complications in relation with those common diseases are immensely bigger than the risks attached to vaccinating children.
Interview with Dr Andrea Ammon, Director of ECDC
SD: What is the best idea to address vaccine hesitancy that you heard recently?
AA: One good example was presented by the Danish Health Authority who have created a ‘Stop HPV’ Facebook site with a 24-hour live chat function operated by medical students, which is really innovative. In general, we need to develop methodologies that allow us to look deeper into the anti-vaxxer movements on Facebook and other social media. This could include analytics which enable us to better understand who is a follower and who is a multiplier of information in these movements. It would be very helpful to have a better understanding of the information flows on anti-vaxxer sites.
SD: What benefits could vaccine registers offer and is there a role for ECDC?
AA: The potential benefits of electronic immunisation registries include the better access to information for patients and doctors, but also the option to better collect aggregated data. In terms of a role for ECDC, we could have a coordinating function and provide technical support to Member States as we already do, as well as collating data. However, the ECDC would not be the host of registers at the EU level.
SD: Should the same topic appear again on the agenda of next year’s EHFG?
AA: I believe it could be interesting to address the topic of vaccine hesitancy again and look at the effect of various national initiatives after further implementation. Also, it is always interesting to discuss progress made on MMR immunisation.
Interview with Dr Arnold Bosman, founder of Transmissible – an international Public Health Consultancy Enterprise
SD: The projects presented during the forum show that there are many legal, political and social questions to solve around the issue of improving vaccine registers. What do you think should be the first step?
AB: In addition to the agreement that the topic of an EU-wide immunisation register requires overcoming obstacles in many dimensions (legal, political, social, technical), there also seems to be an agreement that it needs to be achieved. Therefore, in my view, the first step is that the European Commission formulates a strategic agenda, focusing on all the different sectors. This should include a communication strategy to ensure that all stakeholders (including citizen groups) are aware of how they can benefit.
SD: Tackling the lack of interoperability of registers seems to be a major political barrier. Who could take the lead in solving this problem?
AB: Interoperability has a clear technical aspect, but in the Forum, we heard the statement that the technical side should not be that complex. The issue is funding. This is an aspect that will require political support and that is why a formal strategic agenda will probably help. The ECDC is the best positioned public health agency in the EU to lead the technical approach, and it seems to me that a strong support (including resources) from DG DIGIT would facilitate the process significantly.
SD: Do you agree that the resurgence of infectious diseases is underestimated in the general health policy debate?
AB: The underestimation of infectious diseases was mentioned not only in the session on immunisation registries, but also in other forum sessions, as well as in the plenary. The prevention paradox is one explanation often referred to. Another aspect may be, in my view, that prevention, and by extension public health, probably takes a longer term political commitment than decisions on responding to acute needs in curative health care.
This interviews were conducted by the Young Gasteiner Sarada Das