First I-MOVE+ Scientifc annual meeting

The first Scientific meeting of the I-MOVE+ project was held from 20 to 24 June 2016 in Veyrier du Lac, France. Participants were project beneficiaries and international partners working in the area of evaluation of the pneumococcal and influenza vaccines. The annual meeting was structured in two parts:

-        Part I: 20-21 June -pneumococcal vaccines

-        Part II: 22-24 June - influenza vaccines.

1.1                Summary pneumococcal vaccines meeting

The joint meeting of SpIDnet and I-MOVE+ (pneumococcal vaccines) projects offered the possibility of the projects’ experts to present their experience in conducting invasive pneumococcal disease surveillance and the use of these data for studies on effectiveness and impact of pneumococcal vaccines. It also gave the opportunity to exchange the knowledge with the international partners. Participants were epidemiologists, microbiologists and other experts from the 15 surveillance sites involved in both projects (one or two per site) and international experts.

In the first day of the meeting, SpIDnet and I-MOVE+ pneumo sites presented the 2015 findings and specific studies on effectiveness and impact of used higher valency pneumococcal conjugate vaccines.  The presentations were grouped by geographical regions that allowed to identify similarities and differences between projects’ sites and better understand potential reasons for heterogeneity.

 In the second day of the meeting, the pooled analyses of pneumococcal conjugate vaccines effectiveness and impact of vaccination programmes from the European Union (EU) and European Eocomic Area (EEA) participating countries were presented and exhaustively discussed. The presentations were organised by age groups covered by the two projects (< 65 years SpIDnet and 65+ years I-MOVE+ pneumo). Experts from Germany, Canada (Quebec), US, Latin America presented the data from their countries/regions, allowing for a more comprehensive view of the current status of the Invasive Pneumococcal Disease (IPD) dynamics in the era of higher valency conjugate vaccines. The second part of the day was dedicated to pending questions on IPD surveillance and pneumococcal vaccination in which burning topics were discussed: reduced schedule, mixed schedule, need of the renewal of the global replacement project. The meeting ended with a discussion regarding the projects future, possibility of funding to assure the sustainability of both projects and broadening the scope of the projects beyond the IPD surveillance.

The meeting highlighted the importance of pooling the data for more meaningful results and allowed to identify the priorities for SpIDnet/I-MOVE+ pneumo pooled analyses:

-        Clarifications of specific variables such as underlying conditions and Intensive Care Unit admissions;

-        Increase the sample size for better precision of some sub-analysis;

-        Continue the data validation and finalise the VE and impact pooled analyses;

-        Better dissemination of the projects outputs through publications;

-        Collaboration with WHO on the global replacement project;

-        Further explore the possibility to include other endpoints and specific studies in the current projects or to identify resources for additional components of these projects.

1.2                Summary influenza vaccines

The I-MOVE+ influenza meeting was an opportunity to present the first season results of I-MOVE+ studies and to progress in the harmonisation of methods among I-MOVE+ beneficiaries. The open exchanges with international partners allowed to strengthen the international collaborations and to define the priorities in the area of influenza vaccine evaluations in the elderly population.

The first day of the meeting was restricted to European participants who focused on methodological and logistical aspects of the influenza vaccine effectiveness studies conducted within I-MOVE+: primary care test-negative design studies, multicentre test-negative design at hospital level, studies using electronic databases, pilot study to reinforce the laboratory component of the primary care based studies. Differences between study sites were explored to better understand potential reasons for heterogeneity.

The second and third day of the meeting, experts from US, Canada, Latin America, Australia and Hong Kong joined the European colleagues. The 2015-16 influenza vaccine effectiveness (VE) results from Europe and outside Europe were presented and discussed in-depth. Most of the studies presented were test-negative design (TND) studies either at hospital or primary-care level. Potential biases present in TND were raised and methods to minimise them discussed. In addition, results from EU electronic databases measuring VE using various designs and different outcomes were discussed.
The participants stressed the potential for bias when measuring VE against non-specific outcomes (e.g. pneumonia, ILI).

The group underlined the importance of reporting the impact of influenza vaccination in the elderly population. Impact (total, overall, indirect effect) are public health measures that help understanding the outcomes averted even if the effectiveness of the vaccine is not high.

The last day sessions were devoted to important public health questions in the area of influenza vaccine evaluation: how to study the effect of previous vaccinations, the challenges when measuring influenza VE by vaccine type or brand, the importance of investigating vaccine safety signals, and the effect of statins use on vaccine effectiveness.

Partners from US, Canada, Australia, New Zealand, Latin America and Europe participating in the Global Influenza Vaccine Effectiveness (GIVE) collaboration agreed to continue providing influenza VE results to the World Health Organization for the strain selection vaccine committee. The next GIVE report should be submitted in September 2016.

The meeting allowed to identify the priorities for I-MOVE+ in the coming years:

-        Revise the study protocols for the 2016-17 season;

-        Increase the sample size of the studies to increase the precision of influenza VE for some sub-analysis;

-        Discuss how to validate and communicate the results of influenza VE by brand;

-        Continue the collaboration with international teams to define the best approach to study the effect of                   previous vaccinations;

-        Further explore the potentialities for pooling electronic databases;

-        Assess the feasibility of increasing the number of sites included in the multicentre primary-care case control        study; 

-        Pursue the impact studies including next-seasons data.