Periodic Reporting for period 6 - VITAL (Vaccines and Infectious Diseases in the Ageing PopuLation)
Période du rapport: 2024-01-01 au 2024-12-31
A major challenge in infectious diseases (ID) management is improving efficacy of vaccines and efficiency of prevention in the growing ageing population. VITAL addresses this challenge by assessing the ID burden, identifying the mechanisms of decline of immune responses with age, developing methods to evaluate efficient prevention strategies against ID, and communicating findings to healthcare professionals (HCPs) and ageing adults to increase the impact of future interventions.
WP1 report on the retrospective study estimates the burden of diseases of Pneumococcal Pneumonia and Invasive E. coli in older adults covering incidence, recurrence, and mortality rates, DALY, YLL and YLD. A prospective multisite, multi-country longitudinal case control study in France, Germany, Italy and Spain found reduced functioning in patients hospitalised for ID than in controls at discharge; however, there is no differences in HRQOL, frailty, and functioning between groups, 6 months after discharge. This suggested that the hospitalisation, rather than the ID, affects these outcomes.
The WP2 clinical vaccine study, antibody data analysis showed lower antibody concentrations in older adults following primary Pneumococcal and SARS-CoV2 mRNA vaccination, compared to young adults. T-cell responses after vaccination showed age-related differences in the percentage of donors with a detectable increase in influenza-specific T cells at day 7 and lower (poly)functionality.
A novel metric of immune perturbation that associates with vaccine immune response was developed and validated and 4 serum biomarkers that associate with age-corrected frailty were identified.
WP3 inventoried different blocks of information on available economic models, target population heterogeneity, identification of hot spots of infected aging adults and specific preventative interventions. WP3 focused on an integrated gap-analysis to identify the precise approach in the development of our economic assessment. Static, and dynamic compartment models were developed and a country scoring tool was build that can measure the prevention implementation. Data was collected to create a contact matrix in older adults. Furthermore, the age-structured model and the transferability of our models was developed. Our work emphasizes the critical importance of addressing heterogeneity across population characteristics, methodologies, evidence bases, and vaccination strategies.
WP4 undertook formative research to (1) understand the needs of older adults on vaccination, (2) deepen the understanding of knowledge gaps of HCPs involved in vaccination of older adults, (3) visualise and analyse the network of HCPs providing older adult care, (4) synthesise the knowledge needs, preferred formats and delivery channels to improve education on vaccines and vaccine preventable diseases and (5) develop the content and framework for educational interventions. The framework displays newly created materials, links to data sources on vaccines and vaccine preventable diseases, and training resources.
The WP2 clinical vaccine study, antibody data analysis showed lower antibody concentrations in older adults following primary Pneumococcal and SARS-CoV2 mRNA vaccination, compared to young adults. T-cell responses after vaccination showed age-related differences in the percentage of donors with a detectable increase in influenza-specific T cells at day 7 and lower (poly)functionality.
A novel metric of immune perturbation that associates with vaccine immune response was developed and validated and 4 serum biomarkers that associate with age-corrected frailty were identified.
WP3 inventoried different blocks of information on available economic models, target population heterogeneity, identification of hot spots of infected aging adults and specific preventative interventions. WP3 focused on an integrated gap-analysis to identify the precise approach in the development of our economic assessment. Static, and dynamic compartment models were developed and a country scoring tool was build that can measure the prevention implementation. Data was collected to create a contact matrix in older adults. Furthermore, the age-structured model and the transferability of our models was developed. Our work emphasizes the critical importance of addressing heterogeneity across population characteristics, methodologies, evidence bases, and vaccination strategies.
WP4 undertook formative research to (1) understand the needs of older adults on vaccination, (2) deepen the understanding of knowledge gaps of HCPs involved in vaccination of older adults, (3) visualise and analyse the network of HCPs providing older adult care, (4) synthesise the knowledge needs, preferred formats and delivery channels to improve education on vaccines and vaccine preventable diseases and (5) develop the content and framework for educational interventions. The framework displays newly created materials, links to data sources on vaccines and vaccine preventable diseases, and training resources.
WP1 developed online resources to address ID in aging populations. These include a database containing key data sources for high-burden ID in older adults, a European atlas on frailty prevalence data stratified by age and gender, and an interactive platform visualizing infectious disease burden among Europe's elderly population. These tools could become a critical source of epidemiological data to predict ID burden trends related to demographic changes, or to support preclinical drug development initiatives. The protocols developed in WP1 could serve for extrapolation to burden of disease evaluations in other EU regions. Key insights from WP1 projects stress the importance of standardized demographic stratification (particularly age and gender) when conducting multinational comparative analyses.
WP2 set up a biobank and dataset for current and future studies on immunological mechanisms of vaccine responses. This can be used to support system vaccinology approaches and identify correlates of protection. Novel antibody clustering methods identified the highest risk group in the cohort to be older male participants. Cluster analysis of cell subsets and a novel metric for immune perturbation may aid the prediction and identification of individuals with lower vaccine response. The identified biomarkers can be used to stratify healthy people for their response to vaccination. Serological inflammatory markers can be used to indicate frailty.
WP3’s expected impacts include improved understanding of infection spread dynamics through data collection, better consideration of quality-of-life impacts on older adults, enhanced economic evaluation methodologies, development of a country readiness assessment tool for vaccination strategies, and prioritization of preventive measures within healthcare budgets. It will be a big incentive for decision makers to improve control of the spread of infection in ageing adults through a well-developed and cost-efficient prevention program. Our significant contribution lies in its focus on country-specific investigations. Projections of frailty within populations provide valuable insights into evolving risk profiles, while the development of a country score tool ensures that findings can be evaluated for their applicability across diverse contexts. These efforts strengthen the foundation for tailoring health-economic evaluations to specific settings.
The training and educational tools in WP4 promote prevention strategies such as underused vaccines or new vaccination programs, support informed vaccination decisions among older adults, help HCPs engage in vaccination communication with the older adults and address barriers to vaccination, increase the vaccine uptake, ultimately reducing infection burden, supporting healthy aging, reducing production loss of caregivers, and improve the quality of life.
WP2 set up a biobank and dataset for current and future studies on immunological mechanisms of vaccine responses. This can be used to support system vaccinology approaches and identify correlates of protection. Novel antibody clustering methods identified the highest risk group in the cohort to be older male participants. Cluster analysis of cell subsets and a novel metric for immune perturbation may aid the prediction and identification of individuals with lower vaccine response. The identified biomarkers can be used to stratify healthy people for their response to vaccination. Serological inflammatory markers can be used to indicate frailty.
WP3’s expected impacts include improved understanding of infection spread dynamics through data collection, better consideration of quality-of-life impacts on older adults, enhanced economic evaluation methodologies, development of a country readiness assessment tool for vaccination strategies, and prioritization of preventive measures within healthcare budgets. It will be a big incentive for decision makers to improve control of the spread of infection in ageing adults through a well-developed and cost-efficient prevention program. Our significant contribution lies in its focus on country-specific investigations. Projections of frailty within populations provide valuable insights into evolving risk profiles, while the development of a country score tool ensures that findings can be evaluated for their applicability across diverse contexts. These efforts strengthen the foundation for tailoring health-economic evaluations to specific settings.
The training and educational tools in WP4 promote prevention strategies such as underused vaccines or new vaccination programs, support informed vaccination decisions among older adults, help HCPs engage in vaccination communication with the older adults and address barriers to vaccination, increase the vaccine uptake, ultimately reducing infection burden, supporting healthy aging, reducing production loss of caregivers, and improve the quality of life.