eswi summit report

8/3/2019 ESWI Summit Report

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THE FIRST EUROPEANINFLUENZA SUMMITBRUSSELS, 26 MAy 2011

Organized by

the European Scientific Working group on Influenza (ESWI)


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TABLE OF CONTENTS

Pag 2 Fe

09:30-09:50

hy is influnza a dangrous disas and why should it bof intrst to th stakholdrs?Prof Dr A.D.M.E Osterhaus, head department of Virology,Erasmus MC Rotterdam, The Netherlands / ESWI chair

4

REACHING OUT TO EUROPE'S INFLUENZACOMMUNITY:

THe FIST ANNUAL eSI FLU SUMMIT

10:00-10:20

Council rcommndations on sasonal influnza vaccinationMr. John F. Ryan, Head of the Health Threats Unit, ECDirectorate-General for Health and Consumers

6EU FLU VACCINE POLICY:

AIMING HIGH

10:30-10:50

Vaccination of Halthcar Providrs: th ol of HospitalManagrsDr. Gabriele Andersen, chief occupational health doctor atUniversity Hospital Hamburg-Eppendorf

8HCW VACCINATION:

Ne GeMAN HSPITAL'S QUALIFIe VICTY

11:15-11:35

Vaccination stratgis in th Nthrlands

Dr. Ted van Essen, General Practitioner -adviser to the Dutch Health Council

10THE NETHERLANDS:

VACCINATIN FNT-UNNe

11:45-12:05

Th rol of hospital pharmacists in prvntion andtratmnt of influnzaProf Arnold Vulto, Erasmus MC Rotterdam, The Netherlands

12COMING OUT ...

FM THe HSPITAL BASeMeNT

12:15-12:35

Th rol of pharmacists in vaccination stratgisMrs Suzete Costa, National Association of Pharmacists,Portugal

14VACCINATION TAKE-OFF:

PTUGAL'S PHAMACISTS BLAZe Ne PATH

13:30-13:50

Influnza vaccin manufacturrs committd to supportingnational flu vaccination programmsRichard Stubbins, chair UK Vaccine Industry Group

16VACCINATION IN THE UK:

STNG INUSTY-HC INTeACTIN

14:00-14:20

aising th publics awarnss about influnza in Franc

Prof Bruno Lina chair scientific advisory board of the GroupedExpertise et dInformation sur la Grippe (GEIG)

18RAISING FRENCH AWARENESS

ABUT INFLUeNZA

14:30-14:50

H-europ: assisting countris to obtain influnzasurvillanc and burdn dataDr Caroline Brown, head of the respiratory pathogens

programme, WHO's Europe office Copenhagen

20WHO & FLU:

HeLPING eUPe MNIT ITSeLF

15:15-15:35

Changing influnza policy: th US prspctivDr Litjen Tan, American Medical Association, co-chair NationalInfluenza Vaccine Summit

22GETTING RESULTS,

US-STYLe

15:45-16:10

Th rol of communication and mdiaHanns-Joachim Neubert, President European Unionof Science Journalists Associations (EUSJA)

24MEDIA, MEDICINE & THE PUBLIC:

A LVe-HATe AFFAI

26 SUMMIT CNCLUSINS

PROGRAMME


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Professional awareness about the important burden of influenza on public health continues to grow

in Europe, but theres still no consensus about the best way to monitor, treat and prevent the disease,

the exact policy approach needed to promote the use of influenza antivirals and vaccines, or the most

effective mixture of communication options for reaching the wider public. Getting a more focused

dialogue on the challenges of combating influenza, whether seasonal or pandemic, laid at the heart

of ESWIs first European Flu Summit.

On 26 May 2011, the First European Influenza Summit brought together more than 70 representatives

of organizations of healthcare providers, senior citizens, at-risk patients and public health authorities.

The aim of the meeting was to provide all influenza partners with an informal platform to exchange

good practices and to initiate concrete actions to improve public health protection against influenza.

11 expert lecturers, including the co-chair of the US National Flu Vaccine Summit, addressed the

audience to elaborate on 11 different aspects of the fight against influenza.

This magazine provides a report of the lectures and the discussions held at the Summit. The text can

be copied and distributed freely. Additional questions to the Summits faculty can be asked via ESWIs

management (contact details see below).

The Second European Influenza Summit will be organized in May 2012.

About ESWI

The European Scientific Working group on Influenza (ESWI) is a partnership

organization of stakeholders with a clear mission: to reduce the number of

influenza victims in Europe.

Partnership organizations like ESWI are established to meet specific

objectives and to undertake projects to address problems that neither

partner could tackle adequately on its own. A successful long-term

partnership is built on common grounds. In the case of ESWI, this common

ground is a social concern to improve public health in Europe.

If you require further information please check the ESWI website at

www.eswi.org or contact the ESWI manager, Mr David De Pooter,at [email protected] or +32 3 232 93 42.

FOREWORD


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It is vry important that w all

discuss and dbat this subjct to

crat a platform for flu stakholdrs

to xchang good practics and

initiat concrt actions in europ.

r. Ab strhaus, had of virology at

ottrdams erasmus Mdical Cntr

and eSI chair, told th summit in his

Aiming at a moving targetHeld in Brussels, the one-da event on 26 Ma brought together public and

private sector experts for a rich discussion of the issues in the sector, from

countr-specific vaccination strategies to dealing with a volatile press when

health issues hit the news.

REACHING OUT TO EUROPES INFLUENZATHE FIRST ANNUALESWI FLU SUMMIT

Stakeholder Profile: ESWI

The European Scientific Working group on Influenza brings together

experts, advisors and partner organizations to address flu-related public

health issues that none of the partners could adequately tackle on

their own. Their objectives include public information campaigns, health

surveillance techniques such as how to scale up preparations for a

pandemic and support for the use of vaccines and antivirals.

ESWI works closely with a wide diversity of organizations, which includes:

European Public Health Alliance

World Health Organization

European Respiratory Society

World Organization of Family Doctors

Pharmaceutical Group to the EU

International Diabetes Federation-Europe

Influenza vaccine and antiviral manufacturers

European Lung Foundation

US National Influenza Vaccine Summit

European Medical Association

opning rmarks. nd to dfin

a common policy ground in europ on

influnza, so w ar raching out to as

many stakholdrs as possibl.

Partly inspird by th US National

Influnza Vaccin Summit which

annually pulls togthr mor than

100 public and privat flu-rlatd

organizations undr on roof strhaus

said th eSI stakholdr platform is

guidd by four factors, namly that:

europan halth car systms ar

among th bst in th world

influnza claims mor livs thantraffic accidnts

undrlying disas and high ag

constitut a spcial risk

influnza is a prvntabl disas

strongly bliv that a focus on

bhavioural chang and public halth

policy is indispnsabl for raching th

halth protction objctivs of th eU and

th orld Halth rganisation [H].

Th ovrall goal has to b th rduction

of influnzas burdn on socity and th

numbr of fatal cass in europ, h said.


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T H e F I S T e U P e A N I N F L U e N Z A S U M M I T

B U S S e L S , 2 6 M A Y 2 0 1 1

COMMUNITy:

Memory fades, influenza does not

In his formal prsntation strhaus

rmindd th eSI audinc that th

worlds rcding collctiv mmory

of past pidmics mans thr is a

constant risk that th public forgts

how dangrous influnza can b. How

many popl did from pandmic flu

during th last cntury? Fifty to sixty

million! And yt popl still dont hav

th facts straight in thir had, h

obsrvd.

As an xampl, h pointd to th mythwhich holds that avian flu must always go

through poultry or pigs to rach humans.

now know that it can dirctly infct

humans. Th Hong-Kong flu outbrak

in 1997 was th first rcognizd cas of

th virus jumping from birds straight to

humans. So thy can spill ovr dirctly

to humans, though not from human to

human yt, h said.

And whil any nws about a pandmic

will dominat th hadlins, it is too

asy to ovrlook th dangrs and

halth statistics linkd to ordinary

flu, h said. Bcaus th gntic mak-

up of a flu virus constantly drifts ormutats, this rquirs annually updatd

vaccins sinc thr is no prsistnt

and broad immunity aftr infction or

vaccination dspit som lingring

public prcptions to th contrary.

Stpping up th flow of information

about influnza to th public, th mdia

and spcially europs divrs public

halthcar workr (HC) community

dmands a mor organisd approach,

said strhaus: Thats why this kind of

summit is so important for intracting

with stakholdrs and managing th

dialogu.


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Givn that th Commissions goalfor europ is to achiv a 75-prcnt

vaccination rat in th ldrly and

othr at-risk groups such as halth

car workrs by 2014-2015, yan said

th eU has consistntly advisd th

mmbr stats to adopt national and

rgional campaigns such as ducation

and training to boost information

xchangs on sasonal flu and thus lift

thir sasonal flu covrag rats.

Th 2009 H1N1 avian influnzapandmic rvald a hug divrsity

of vaccination approachs, though h

said som common obsrvations could

b drawn basd on th Commissions

rviw of vnts surrounding th

pandmic as wll as subsqunt

valuations by H, th europan

Cntr for isas Control (eCC), th

europan Mdicins Agncy (eMA) and

national assssmnts. For xampl, on

of th Commissions most importantfindings of th 2009 pandmic was th

rol that halth car workrs playd in

influncing th gnral publics attitud

toward vaccination.

ithout HCs ngagmnt

and support, th ffctivnss of

communication to patints and th

public will not b high, which mans

risk groups will b highly impactd,

yan obsrvd.

n big problm was th disconnctionbtwn th advic going to th gnral

public and that going to HCs about

th sriousnss of th pandmic. As

a rsult, many HCs did not tak it

sriously and so thy did not rcommnd

vaccination to thir patints. saw

this in many mmbr stats, h said.

It boils down to dialogu, which is why

it is so important to rais awarnss

among all stakholdrs.

Influenza vaccination policies and public information campaigns var greatl

across the 27 EU nations all the more so, as health care is a national

responsibilit. Steering them toward more coherence in their collective effort

to reduce the burden of influenza on societ falls primaril to the EuropeanCommission.

Raising Europes vaccination rates and developing mutual-support mechanisms

for the availabilit of vaccine stocks are two of the biggest polic challenges

facing the EU in this area, as explained b the ESWI summits second speaker,

John Ran head of the health threats unit at the European Commissions

Directorate-General for Health and Consumer (DG SANCO).

EU FLU ACCINE POLICy:AIMING HIGH


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B U S S e L S , 2 6 M A Y 2 0 1 1

No hard power but things are moving

As dadly as thy ar, pandmics arstill rar. Th mor common killr

is sasonal flu. Askd whthr th

Commission is giving any thought to

a collctiv approach to combating

sasonal flu, yans answr was

quivocal.

Noting that th Commissions hard or

binding lgislativ powr in th halth

sctor is limitd to a fw aras, h

said unfortunatly, sasonal flu dos

not fall in that catgory so w ar

rstrictd to soft masurs such as

[non-binding] rcommndations. But

w do issu rports on implmntation

of ths rcommndations, which can

b mbarrassing if a mmbr stats

finds its nam at th bottom of th list.

As far as Commissions 75-prcnt

targt vaccination rat for at-risk groups,

only on country Th Nthrlands has rachd that goal, for xampl.

yan admittd that th gap btwn

th targt and rality is larg. But h

also insistd that th ssntial thing is

to fix indicators and hav a procss for

achiving thm. r alrady prparing

for a joint procurmnt mchanism

[s accompanying box] for vaccin

procurmnt, and this could lad to

othr joint masurs such as rinforcd

prpardnss, which is currntly don

only on a voluntary basis.

The 2009 pandemic & vaccines: more EU solidarity needed

Many of the EU27 were in a difficult vaccine situation when the 2009 pandemic hit, according to Ryan. This pitched one

member state against another in the chase after vaccines, and some lost out when trying to vaccinate their citizens. As

a result, we saw shortages in certain EU nations. This is unacceptable in an EU where solidarity and health security

is a principle, he said.

To avoid such a situation the next time a pandemic hits, the EUs Council of Ministers asked the Commission to develop

a voluntary mechanism for the joint procurement of vaccines and antivirals a joint framework proposal which will be

presented in December 2011 to national health ministers for their discussion and approval.

According to Ryan, such an approach would offer three advantages. It would:

boost solidarity by guaranteeing a minimum level of equitable access to vaccines for priority risk groups

group together the member states purchasing power to produce better contractual terms regarding

price, liability and delivery

make the EU approach adaptable to existing national procurement practices

The Commission is convinced that joint purchasing [of vaccines and/or antivirals] would boost our level ofpreparedness, observed Ryan.


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In th yars prcding th 2009

pandmic, UKes HC-vaccination

rat was virtually no diffrnt from that

prvailing across Grman HCs as a

whol: around 15-to-20 prcnt.

But with th prospcts of pandmic

onslaught, Andrsn and tam

dcidd to tak th bull by th horns

and str thir organisations HCs

to highr hights. Th first thing thy

did was to crat an in-hous task

forc to coordinat th pro-vaccination

campaign.

A ky objctiv was to giv vry clar

information to all our mploys via

multipl channls such as nwslttrs,

postrs, mail, and so on and thn

to rinforc this with rgular visits by

vaccination information tams to all

sctors of th hospital, sh said.

also st up an in-hous hotlin for

qustions from staff mmbrs and,

most important, local vaccination points

across hospital at placs such as th

intnsiv car unit, mrgncy rooms

and th padiatric clinic. All this was

don to mak vaccination as asy as

possibl.

Ironically, on of th factors that pushd

UKes halth workrs to th vaccin

station was prsonal discomfort, which

aros for thos who chos not to gt

a flu shot. For unvaccinatd HCs,

w mad it obligatory to war th N95

[fac] mask to protct thmslvs

and patints. It turnd out this was a

main way to gt thm to com gt a

vaccination: thy did not lik waring

th mask all day. This was not asily

accptd but thy had to do it bcaus it

cam from our managmnt board and

thus could not b rjctd.

Among Europes largest hospitals, and the biggest in northern German, is the

Universit Hospital Hamburg-Eppendorf (UKE). With 4,500 doctors, therapists,

nurses and other medical personnel on its paroll, UKE handles 76,000

in-patients and a staggering 250,000 out-patients each ear.

How UKE managed to chalk up an astonishing rate of HCW vaccination during the2009 flu pandemic onl to see the momentum plunge once the pandemic wave

was over offers lessons learned for all, as Dr. Gabriele Andersen, UKEs chief

occupational health doctor, told the ESWI summit.

HCW ACCINATION:ONE GERMANHOSPITALS

(qUALIFIED)ICTORy


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B U S S e L S , 2 6 M A Y 2 0 1 1

HCW Vaccination: Firm Guiding Hand Needed

Converting HCWs to the self-vaccination cause demands both awareness-raising and firm guidance from management,

according to Andersen. The idea is to get the right mixture of positive incentives and negative disincentives, she said.

To reverse her organisations post-2009 pandemic slide in enthusiasm among HCWs to get a vaccination, Andersen

said UKEs management is now mulling a new strategy based on a set of options that range across the following:

better ways of distributing information to HCWs

the use of only vaccinated staff in certain areas such as patients with immune deficiency

declination forms whereby HCWs formally declare their rejection of vaccines

obligatory flu vaccination

a standing obligation that unvaccinated HCWs must wear a mask

Asked if UKE negotiated an accord with its hospital unions that all unvaccinated workers would have to wear a mask,

Andersen said: Yes, they agreed to strictly follow the orders of the hospital management. But, even so: if you cant get

the consent of all players, you simply wont be successful.

Big-time results but pandemic only

Andrsns wll thought-out plan ofattack dlivrd solid rsults. uring

th 2009/2010 pandmic flu sason th

rat of vaccination among UKes halth

car workrs shot up to an amazing 74

prcnt, thus catapulting th hospital

far abov th national avrag. But this

victory did not last for long. By th

tim th 2010/2011 flu sason rolld

around, th HC slf-vaccination rat

plummtd to 27 prcnt.

hat happnd and why?

askd our HCs why thy rjctd

vaccination this yar and th rasons

wr fairly prdictabl, obsrvd

Andrsn.

Among th main rasons was th

misprcption that immunity lingrs

from th prvious yars pandmic fluvaccin. thr rasons givn wr that

vaccins provid insufficint protction

or that thy caus influnza. And thr

wr also concrns about advrs

raction to vaccins and simply far of

th ndl, sh said.

Food for thought

Mandator vaccination (as successfull implemented in the Universit

Hospital Hamburg-Eppendorf) is a controversial strateg that pits

healthcare worker autonom against patient safet. The ethical

argument that healthcare workers have a moral obligation to first

protect themselves and then to protect their patients seems to

graduall win ground. The discussion continues


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Indd, th Nthrlands bgan

organising its stakholdr dbat as

arly as th bginning of th 1990s

with th cration of th utch Influnza

Foundation (IF) in 1992 a broad

coalition of public halth authoritis,

profssional mdical associations,

pharmacists, insuranc companis,

disas-spcific patints groups and

associations rprsnting th ldrly.ith its funding shouldrd 50-50 by

industry and th Ministry of Halth, IF

was th countrys first public-privat

partnrship in th halth sctor, and it

usd all modrn mdia to driv hom its

cntral and positiv mssag ork

on your halth! about th bnfits of

influnza vaccination.

This was a push-and-pull stratgy to

gt patints in to s thir doctor, said

van essn.

The Netherlands is among the few European countries that achieve a high rate

of seasonal flu vaccination ear after ear. For example, WHOs recommendedvaccination uptake target for the elderl (i.e., 65 ears and older) in 2010 was 75

percent. The Dutch were not onl the onl nation in Europe that reached that goal

but exceeded it with more than 80-percent of its elderl with accompaning risks

getting vaccinated.

We have a vaccination rate of around 60-to-70 percent for the population as

a whole. And for the common childhood vaccinations like measles and rubella

we have rates of almost 95%, speaker Ted van Essen, general practitioner and

adviser to the Dutch Health Council, told his ESWI audience. But weve been

refining the strateg for a long time.

THE NETHERLANDS:ACCINATIONFRONT-RUNNER

1,5%

71

lung

90

80

70

60

50

40

3020

10

0

Influenza vaccination rate by risk group in The Netherlands, 2010

80 81 83 63 75 83 61

hart M kidny GPs 60+ 60+ H 60+ L

Tackn MAJB t al

Although th IF casd in 1996,

utch GPs pickd up its idas and hav

bn running with thm vr sinc to

visibl ffct, givn th countrys high

vaccination rat.


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B U S S e L S , 2 6 M A Y 2 0 1 1

Vaccination Dutch-style

A number of success factors account for the Netherlands impressive vaccination rates. According to van Essen, these

include:

one professional held accountable: the GP with a patient list system a national electronic medical records system that allows physicians and HCWs to identify names and addresses of

all at-risk patients, (i.e., 30% of the population)

free vaccinations for patients at-risk

a guaranteed fee for GPs who administer the vaccine

centralised government purchasing of vaccines

easy paperwork for the GP and convenient vaccinations hours including evenings in certain cases for patients

a simple campaign based on a postcard invitation-with-flyer from the GP

systematic feedback to evaluate effort and results.

Ive tried to find the one reason why this whole system works so well, but thats not the answer, he said. Its really

the balance and combination of all these factors the shotgun approach that explains its effectiveness.

It dont come easy

Th Nthrlands high influnza vaccinrats do not com casually: thyr th

rsult of yars of stakholdr ffort and

positiv aggrssiv campaigns to gt

utch patints in to s thir doctor

initiativs which van essn strongly

supports. You only hav to look at th

bfor-and-aftr rsults, h said.

Bfor 1991, th public got an annual

lttr from halth authoritis and som

invitation cards from industry. Thr was

no f-for-srvic for th GP and th

patint had to go to th pharmacy with a

prscription.

From 1992 on with th cration of th

utch Influnza Foundation and othr

initiativs things bgan to chang,

howvr. Patint magazins carrying

th vaccin mssag wnt from 23

in 1992 to 45 in 1996 and nwspapr

articls jumpd from 34 to 271! h said.

Obligatory HCW vaccination?

Th utch vaccination succss rat notonly applis to at-risk groups and th

population in gnral but also to its

HCs. In 2009, for xampl, pandmic

vaccination rats among its GPs was 85

prcnt and that for HC staff was 76

prcnt. evn for that yars sasonal

flu vaccination, th rats wr 63 and 60

prcnt, rspctivly.

Most countris would b mor than

plasd with thos lvls but van essn

thinks big and controvrsially. I

think w should just mak vaccination

mandatory for HCs, h said.

That sparkd no littl dbat from his

eSI summit listnrs, with som

participants arguing against th ida

out of concrn that HCs might confid

to a patint that thy wr forcd to gt

a vaccination, thus snding th wrong

mssag.

Van essn concdd that point, butsaid its a qustion of public ducation.

ethically, you could also argu th issu

from th othr dirction: that HCs

hav a moral obligation to first protct

thmslvs and thn to protct thir

patints. Aftr all, th hpatitis B

vaccin is mandatory for surgons or

ls thy ar xcludd from trating a

patint. So thr is a prcdnt for such

an approach and I think w should build

on that.


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Th convntional imag of th hospital

pharmacist as dispnsing mdicin from

a littl window in th hospital basmnt

is long outdatd, said Vulto. Indd, his

profssion is on of many that contributsto todays incrasingly complx

stakholdr dialogu on vaccination

policy and how to implmnt it.

hav 30 staff working in our

hospital who ar all focusd on

spcialisd pharmacological car,

said Vulto. Noting that post-graduat

spcialisation is now indispnsabl in

th pharmacological sctor, h said

hospital pharmacists hav turnd

into spcialists daling with high-

risk influnza patints who hav to b

innovativ and quick in thir dcisions,

as that oftn mans th diffrnc

btwn lif or dath.

bsrving that his profssion camout of th clost in h 1960s, Vulto

said hospital pharmacists ar now

far mor srvic-orintd. Today

its car orintation: spcialisd

pharmacological car basd on

prsonalisd mdicin and bdsid

pharmacy tchniqus.

Vulto is a mmbr of th 21,000-strong

europan Association of Hospital

Pharmacists and chif ditor of itsin-hous publication, th europan

Journal of Hospital Pharmacy.

Traditionall, hospitals in-house pharmacists were largel unseen for the

important role the pla in delivering the right medicine to the patient and the

right pharmacological advice to medical staff. But pharmacists increasingl plaa pro-active role in hospitals b intervening, often at bedside, as the flu patients

specialised pharmaceutical care manager, as Arnold ulto, professor of Hospital

Pharmac & Practical Therapeutics at Erasmus Universit Medical Center, told

the ESWI summit.

COMING OUTFROM THE HOSPITALBASEMENT

Food for thought

Studies have shown that influenza vaccination of healthcare

workers reduces emploee illness and absenteeism. In nursing

home settings, vaccination of healthcare workers decreases the

impact of influenza on the residents. And et, vaccination rates

among European healthcare workers are generall low.


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B U S S e L S , 2 6 M A Y 2 0 1 1

Pharmacists: advocating vaccination in the hospital

If our sector wants to address the vaccination challenge, then we need to move away from promoting the balancedview and go for a more pro-active stance, Vulto told the ESWI summit. But this means that the public needs a

consistent vaccine message that is repeated over and over again, following a long term communications strategy.

According to Vulto, such a strategy should be based on a set of simple, but positive messages about the benefits of

vaccination, namely that:

it stimulates ones own immune system to protect himself, thus mimicking natural immunity

the responsible citizen gets vaccinated to prevent the virus from spreading to family, friends and colleagues

the call-of-duty is even stronger for health care staff to protect vulnerable hospitalised patients

Vulto said the level of mis-information about vaccines that circulates among HCWs can be very persistent, despite the facts.

Ive heard everything from fears that the vaccine is dangerous to a refusal to be manipulated. It is astonishing to

learn sometimes how little hospital staff know about vaccinations, he said. But it also shows that they need anindependent information source, which hospital pharmacists can and should play as informed facilitators.

hil hospital pharmacists ar today

rgardd as indpndnt information

sourc on pharmacuticals in th

hospital, Vulto said thir ability to

provid indpndnt advic on influnza

cass dpnds havily on rapid accss

to up-to-dat and rliabl informationsourcs, which was not always th cas

as th 2009 pandmic unfoldd.

Digging for the data fast

Pharmacological information about

th 2009 pandmic was unvn and

somwhat confusing, according to Vulto.

Although th europ Mdicins Agncy,

H and various national instituts

vntually providd nough pandmic

vaccin information to nabl him and

othr pharmacists to proprly advis

thir hospital staff, Vulto said it was an

uphill battl to displ misplacd public

fars about th vaccin.

Som countris providd information

fastr to pharmacists than othrs.

Grmany put out wkly updats during

th pandmic, which wr vry usful.

But th transparncy of information inothr countris could hav bn much

bttr, h said.

This was our first xprinc with larg-

scal pandmic vaccin production and

it raisd a lot of qustions within our

community. No on rally knw what

typ of antign or adjuvant was bst, for

xampl, or whthr w should hav

rcommndd boostr shots for at-risk

groups, h said.

evntually, howvr, w found good

data about typs of antign and antign

sparing stratgis, information about

boostr guidlins and updats about

vaccin production limitations. In th

nd w did gt th guidanc w ndd

on ths issus, obsrvd Vulto.

The European Associationof Hospital Pharmacists

AeHP is th fdration of nationalassociations of hospital pharmacists,uniting mor than 21.000 hospitalpharmacists in 31 countris.

The European Journal

of Hospital Pharmacyis th official eAHP journal.www.ahp.u


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I was dirctly involvd in this campaign

and it took a lot of prparatory work

to bring th public and our pharmacy

sctor on board, said Costa.

Th rform allowd pharmacis

to xpand thir scop of activity into

nw aras, including immunisation. In

addition to th vaccination intrvntion

modl it dfind, ANF providd a training

programm to prpar pharmacis for

th nw campaign and othr support

masurs.

This was a short-trm but massiv

training programm for pharmacists all

across th country, said Costa, adding

that ANP providd a list of nurss for

intrstd pharmacis: Basically,

w offrd our constitunts a choic

btwn hiring a nurs or having

training thmslvs.

Taking plac ovr a 12-wk priod

in advanc of th 2008/09 flu sason,

th programm saw narly half of

Portugals 1914 pharmacists compltth vaccination training cours.

As a rsult, th numbr of flu vaccins

administrd in Portugus pharmacis

during th 2008/09 sason ros to as

much as on-fifth of th national total,

with pharmacists thmslvs as

opposd to on-sit nurss carrying

out th grat majority of immunisation

srvic on thir prmiss.

B stroke of luck Portugal launched a new national flu vaccine campaign just

before the 2009 pandemic struck. A ke part of the initiative was a new law to

allow the countrs pharmacies to administer flu shots.

The countrs National Association of Pharmacies (ANP) was heavil involved in

the effort, designing the intervention model and persuading its sector and the

public to embrace it. How far this ma go is uncertain, but the results to date

have been encouraging, according to Suzete Costa, pharmacist and researcher

who addressed the ESWI summit on ANPs behalf.

ACCINATION TAKE-OFF:PORTUGALS PHARMABLAZE NEW PATH

1,5%

0,7%

5,5%

2,3%

8,4%

3,1%

11,3%

0 50 100

350

300

250

200

150

100

50

0

1,0%1,4%

Estimate of the contribution of pharmacies for the influenza

immunization coverage in Portugal in 2008/9

% of vaccins administrd in th participating pharmaciscomparativly to thos who snt thir rcords

Total < 65 yars 65 yars

Thousandsofpatientsvaccinated

inpharmacies

Sourc: CeFA


15/2815


B U S S e L S , 2 6 M A Y 2 0 1 1

CISTSPrescription-vs-dispensation

Costa has strong, if not controvrsial,

viws about th pro-activ rol that

pharmacists should play in hr countrys

battl to prvnt influnza.

think qualifid community

pharmacists in europ should b

abl to administr flu shots to high-

risk patint groups such as th agd

without a prscription. This could b

don via a protocol with national halth

authoritis somthing similar to what

occurs in th Unitd Stats, sh told

hr eSI audinc.

Sh holds th viw that, at th vry

minimum, pharmacis and pharmacists

should b includd in flu pandmic

stratgis, particularly whn a rapid

rspons that must b administrd

clos to th population is rquird.

This would srv to promot prvntiv

masurs and offr accss to ssntial

mdicins and srvics, obsrvd

Costa.

For th 2009 pandmic howvr Lisbon

ruld that th pandmic vaccins would

b handld via national halth cntrs,

allowing sasonal flu to b administrd

as an option at pharmacis.

How much farthr ANP can carry out its

intrvntion goals rmains to b sn.

Thr is a split btwn thos who

prscrib and thos who dispns in our

country, vn if most mdicin coms

from pharmacis, whthr rimbursd

or not, sh said.

Costa acknowldgd, howvr, that

th sctors libralisation may hav its

limits. In our country thr ar crtain

vaccins for prgnant womn, for

xampl that must b don at national

halth car cntrs, so that is not part of

our ANF plan, sh said.

Portugals intervention model for its pharmacists

ANF based its intervention model on the US experience with its own pharmacists. Models were developed for vaccine

delivery, emergency procedures and the creation of immunisation records to help Portugals pharmacists provide the

new service. All pharmacies were invited to participate, with ANF placing special emphasis on targeting older adults

those 65 years and above who had an influenza vaccine prescription.

The wider intervention models objectives were to:

raise public awareness of the new pharmacy-based service inform target populations about the benefits of immunisation

track the percentage of vaccines administered in pharmacies and how pharmacies contributed to the national

influenza immunisation rate

The results were encouraging, according to Costa.

Approximately 60 percent of Portugals 2670 pharmacies participated in ANFs intervention programme and of these,

nearly half sent in immunisation data to ANF. Even more striking, 91 percent of all the immunisations carried out in the

drug stores were performed by the pharmacists themselves, with each pharmacy treating an average of 206 patients.

The positive trend has continued since then, with the number of participating pharmacies rising from 1,588 in 2008/09 to

1,622 in 2009/10. Meanwhile, the number of pharmacies that sent in data jumped a spectacular 33 percent from 733 to 1,033.


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kp a rgular dialogu with all

four UK halth dpartmnts rgarding

vaccins, production volums and

futur planning possibl changs to

govrnmnt rcommndations, saidStubbins.

Indd, UVIGs companis ar tightly

pluggd into th UKs annual cycl of

activity, starting in Fbruary with Hs

flu virus guidlins and nding with th

last dlivris of vaccins in cmbr

ach yar. Th group also works with

clustrs of GPs, who collctivly

ngotiat and buy thir vaccins stocks

dirctly from th manufacturrs still a

rar approach across europ.

On the uptake

Th UKs approach to vaccination has

dlivrd good rsults so far, particularly

to at-risk groups. For th last fiv yarsth uptak rat for th UKs ovr-65

group has hovrd at avrag of 70

prcnt ach yar and somtims up

to 75 prcnt, said Stubbins. v

also sn th vaccination uptak among

HCs shift from 16 prcnt in 2008 to

34 prcnt in 2010/11.

According to Stubbins th UK still

nds to improv its rat of uptak

for th ovrall population, howvr.

Noting that on of th problms was

th lack of a national mdia campaign

in 2010, h said this dfinitly had

an impact on uptak. think this

should b rinstatd. thr tasks

rquir chcking th programms

ovrall cost ffctivnss and rviwingintrvntion options such as lowring

th UKs currnt 65-yar ag limit for

fr vaccins to th ldrly.

H also thinks thr should b tightr

collaboration among all vaccination

stakholdrs and a gratr willingnss

on industrys part stand up and addrss

issus in public. nd to maintain

public confidnc in our sctor so w

nd to addrss ths issus in an

organisd and consistnt mannr, h

said.

The UK is a strong supporter of public-private partnerships and the pharmaceutical

sector is no exception.

Representing seven vaccine manufacturers, the UK accine Industr Group

(UIG) is the sectors polic voice and it liaises closel with government

health authorities, GPs and other HCWs and the Association of the British

Pharmaceutical Industr to raise public awareness of the benefits of vaccination,

Richard Stubbins, UIG chairman, told the summit.

ACCINATION IN THE UK:STRONGINDUSTRy-HCW

INTERACTION


17/2817


B U S S e L S , 2 6 M A Y 2 0 1 1

Stakeholder Questions to UVIG

Q: Your HCW vaccination uptake rate in2008 rose steadily from 16 to 35 percent

for 2010/11. How did this happen?

Stubbins: Part of th ris was du to

th pandmic, and part to th strong

mphasis givn by th NHS [th UKs

National Halth Srvic] to mak sur

that HCs wr immunisd.

Q: Is it common practice that vaccination

information leaflets are circulated in the UK

with a vaccine manufacturers name on it?

Stubbins: Th laflt is snt out by th

doctor, but it dos contain th companysnam bcaus thy paid for it.

Q: Wouldnt it be better to remove their

name from them?

Stubbins: spit th succss of th UKs

influnza campaign, thr is still a nd

to boost confidnc in vaccins. Thr

is skpticism toward govrnmnt and, it

is tru, also industry. But w think our

sctor is upholding its part by providing

postrs, cards and signs that ar bright

and impactful in ordr to mphasiz th

risks and th nd for vaccination.

Q: Do you see any fundamental changes

needed to the UKs programme?

Stubbins: An ag-basd stratgy would

b much asir to implmnt than a

risk-basd on. That said, it would still

hav to offr protction for all at-risk

groups and includ financial incntivs

for GPs and th participation of industry.

Fact file: The UKs flu vaccine programme

The UKs national programme for vaccination is based on:

priority for 65 years and over

priority of at-risk groups that include chronic illness, healthcare workers and pregnant women

procurement linked to direct purchases by GPs from manufacturers

reimbursement by government to GPs for the cost of vaccines

financial incentives for GPs to procure vaccines and administer them to all those eligible

Why has this been successful?

Such an approach sets clear and consistent targets nationally and is reinforced by immunisation coordinators working

at the local level, recommendations from the governments Chief Medical Officer (CMO) and by the procurementincentives for doctors, observed Stubbins.


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Of the millions who suffer from influenza each ear in France between two and

eight million people annuall the effects of the disease hit the countrs elderl

the hardest. How to work with the government and scientific communit to abate

these and other flu victims is among the main polic goals of Frances industr-

supported Group dexpertise et dinformation sur la Grippe (GEIG), Bruno Lina,

chairman of GEIGs scientific advisor board, told the summit.

RAISING FRENCHAWARENESSABOUT INFLUENZA

Vaccinometre: Real-time monitoring of vaccine uptake in > 65


19/2819


B U S S e L S , 2 6 M A Y 2 0 1 1

Similar to th UKs vaccination

campaign approach, Francs scintific

and industry stakholdrs work closly

with ach othr and with th national

Ministry of Halth to rach out to th

gnral public. hil all sgmnts of

th population ar targtd, particular

ffort has gon toward prsuading

Francs ovr-65 citizns to protct

thmslvs against sasonal influnza.

Th ovr-65 crowd may qual only

5-to-10 prcnt of influnza victims

ach yar in Franc, but thy rprsnt

90 prcnt of all daths rlatd to th

disas, said Lina, adding that on

of GeIGs ky functions is to carry out

ral-tim survillanc of vaccin uptak

across this at-risk group in Franc.

GeIG has bn shaking up idas

sinc th bginning by continually

launching its own initiativs, Lina told

his audinc. For xampl, it bgan

following of vaccin uptak trnds in

1990, following by pandmic planning

as arly as 1993. By 2008 it was doing

ral-tim survillanc of vaccin uptak

and, for th 2011-2012 flu sason, it will

organis xhibits in hospitals on th

bnfits of vaccination.

do this to track th trnd

vaccination uptak during a campaign

so that rsourcs can b rdirctd if

th uptak is infrior to xpctations.

This also has th addd advantag of

providing data to policymakrs about

th trnd, h said.

GEIG: how does it work?

GEIG was founded in 1986 to promote knowledge about influenza and its vaccination, and is financed by five commercial

laboratories involved in the distribution of vaccines across France. The five are: Sanofi Pasteur MSD, GSK, Pierre

Fabre, Abbot Products SAS and Novartis Vaccines.

With its industrial support balanced by the independent expertise of GEIGs Scientific Advisory Board, the organisation

has been directly involved in Frances national influenza vaccination campaigns for the past 25 years.

The organisation devotes much of its effort to awareness-raising about the facts surrounding vaccination. It worksclosely with French health authorities during vaccination campaigns and with the scientific community via annual

influenza conferences, GEIGs website and scientific journals.

It also liaises with the press across all media channels to provide regular updates on the evolution of flu viruses,

descriptions of its epidemiology and trends in vaccine uptake. We organise so many regular briefings with the press on

all of these subjects that you could even argue that we are doing the duty of the Ministry of Health! said Lina. Thats

how well known we are to the French press.


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Noting that SAI is charactrizd

as dvloping ovr svn days and

rquiring ovrnight hospitalization,

whos symptoms includ a history

of fvr of at last 38C coupld with

coughing and shortnss of brath or

difficulty in brathing, Brown said good

survillanc mans w nd th ag

stratification for th virology, and th

outcom data for SAI patints: how

many did, how many wr hospitalisd

and how many wnt into intnsiv car?

And th data has to b comparabl

across rgions, btwn sasons andgoing back in tim.

Hs survillanc of SAI in europ

startd in 2001 with about 14 nations and

is now widly carrid out in coopration

with th eUs europan Cntr for

isas Prvntion and Control (eCC).

Today it is don by about 50 europan

countris, using th platform calld

euroFlu, which allows ach to obtain

influnza survillanc and burdn data

about SAI, obsrvd Brown.

Sentinel flu surveillance

Brown said SAI survillanc

ncompasss four broad goals:

monitoring th virus typs and subtyps

and thir antignic and gntic

charactristics of locally circulating

flu strains for annual vaccin strainslction; providing rprsntativ

viruss for vaccin strain production;

monitoring locally circulating viruss for

thir snsitivity to antivirals; and finally

tracking clinical data from outpatints

to dtrmin th timing and intnsity of

th nxt influnza sason.

Sentinel surveillance is the collection and analsis of data b institutionschosen for their geographic location and their abilit to accuratel diagnose and

report high ualit data. This is ke to the WHOs goal of collecting virological

information on patients with smptoms of severe acute respirator infection

(SARI), often a first sign of an influenza outbreak, Dr. Caroline Brown, head of

the respirator pathogens programme at WHOs Europe office in Copenhagen,

explained to the ESWI summit.

WHO & FLU:HELPING EUROPEMONITOR ITSELF


21/2821


B U S S e L S , 2 6 M A Y 2 0 1 1

According to Brown th countris of

strn europ hav a good track

rcord of monitoring SAI and sasonalinflunza vaccin us. But europs

southrn and astrn stats ar

still strngthning thir community

survillanc and introducing sntinl

systms for th survillanc of SAI, sh

said, adding that th gratr challng

and nd for sntinl survillanc lis

mainly to th ast of europ in th

Balkans and Cntral Asia.

As a rsult, Hs euroFlu systm

was xtndd in 2009 across th

euro-Asian continnt to mbrac thfollowing countris (with ussia split

into svn districts):

Albania

Armnia

Gorgia

Kazakhstan

Kyrgyzstan

Malta

omania

public of Moldova

ussian Fdration

Srbia Ukrain

Th survillanc systm shows that

Kyrgyzstan has th lowst influnza

vaccin uptak of all, sh said.

Stakeholder Questions to WHO

Q: The Commission gets a weekly report to see if there is any influenza event that needs to be shared with the member

states. How is this done at your end?

Brown: We coordinate our surveillance data with the ECDC; its as straightforward as that.

Q: Do national systems in Europe overlap with EuroFlu and the ECDC?

Brown: EU countries report to the ECDC, which automatically transfers the data to EuroFlu and then to WHOs own

FLUID [Flu Informed Decisions] system. This is antigenic information were talking about influenza A & B and other

characterisations that go to EuroFlu via ECDC.

Q: Is there any redundancy between those systems?

Brown: Technically yes. But politically its difficult to get all the countries to report.

Q: What is the more urgent SARI surveillance task in your view?

Brown: We think country-level collaboration is the priority to improve data quality via legal and technical aspects, with

a stress on sustainable components. Work is also needed to gather denominator data [population statistics] for their

hospital impact and preliminary burden estimates.

Q: Are you happy with the results so far?

Brown: Well, these systems [across south-eastern Europe and Central Asia] are still young and we all are still learningthe best practices. But so far, the SARI clinical data are consistent with virological trends in the participating countries.


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A ky pillar to th US govrnmnts

(USG) flu vaccination stratgy was th

govrnmnts dcision in 2010 to finally

rcommnd univrsal flu vaccination for

all popl abov th ag of six months.

This was twinnd with a standing

targt vaccination goal of 90 prcnt

and intrvntion bginning as soon

as sasonal influnza vaccins ar

availabl and continuing throughout

th sason.

hat was th rational for moving awayfrom th USGs prvious st of tailord

risk-basd rcommndations?

Th vaccination guidlins had simply

grown too complx to b practical,

said Tan. In 2007 w had 12 spcific

vaccination targt groups, and it was just

too much to ask GPs to rmmbr all

this. ith a univrsal rcommndation,

thr is no ambiguity about th issu.

Also, it was mor difficult for patints

to slf-idntify basd on risk conditions,

whil th covrag lvl across all th

targt groups was, in gnral, low.

But vn a mor straightforward,

asy-to-undrstand guidlin dosnt

guarant that vaccination rats will

automatically ris, said Tan. No mattr

how w ndavour to ducat th public

or giv away fr vaccins or try to mak

th whol procss fun and convnint

som organisations vn throw pizza-

plus-vaccination partis th rat still

only gos up to about 75 prcnt in th

US. simply hit this stagnation point.

For xampl, th US vaccination ratachivd undr th nw univrsal

rcommndation for th 2010/11 flu

sason ros only slightly compard to

th 2009/10 sason: from 41 prcnt

of all popl ovr six months of ag to

42 prcnt. Morovr, th rsults for

many sub-catgoris of th population

wr not much bttr, with vaccination

for th ovr-18 crowd bumping up only

on prcntag point, from 40 to 41. Th

rspons of th ovr-65 population wasncouraging, howvr, with vaccination

rising from 70 prcnt in 2009/10 to as

much as 75 prcnt th following yar.

As for vaccination of halth car

workrs and how to st th conditions

for this to happn, Tans position was

unambiguous.

nd a nw modl such as

mandatory vaccination for HCs, h

said. You can asily gt 90 prcnt

covrag if its a condition of mploymnt.

Not surprisingly, in hospitals whr that

is th cas, wr sing 99 prcnt of

thir HCs gtting vaccinatd.

Pushing the envelope

Pointing to what h calld a failur of

th US publics halth blif modl,

Tan said th govrnmnt is working

with a broad rang of stakholdrs to

push th vaccination nvlop in all

dirctions. For xampl, US pharmacis

now aggrssivly markt thir vaccins

stocks which has addd th sidbnfit of driving patints to thir GPs

to gt a prscription, said Tan.

Arguabl, the US government has pushed polic innovation and market

mechanisms farther than an other nation in the effort to push up vaccination

rates across its 300 million-plus population. Is this the wa ahead for European

countries or does it work best in the free-for-all market conditions of America?

While some aspects of the US approach ma be too daring for some, theres no

discounting the countrs vigorous stakeholder dialogue on vaccination or its

willingness to experiment, as Litjen Tan, co-chair of the US National Influenza

accine Summit and director for medicine and public health at the American

Medical Association (AMA), told his ESWI listeners.

GETTING RESULTS,US-STyLE


23/2823


B U S S e L S , 2 6 M A Y 2 0 1 1

Gnral mrchandis stors ar also

gtting into th act, with mor than a

quartr of th abov-65 crowd in th USgtting thir vaccins at larg discount

pharmacis or vn at suprstors

such as alMart.

hy ar th stors doing this?

Bcaus of dmand: many patints find

it inconvnint to go to thir doctors

offic. This is a vry intrsting trnd

that w ar bginning to s in th US,

h obsrvd.

Stakeholder Questions to Tan

Q: What about monitoring if you do

vaccination in supermarkets?

Tan: Admittdly th situation in th

Unitd Stats is a bit diffrnt. At-risk

patints about 40 prcnt of thm

gt thir vaccination from thir GPs.

Th othr 60 prcnt dos this via

pharmacis, rtail stors and othr

accss points.

Q: Who pays for the vaccine?

Tan: ur paymnt systm is vry

complicatd. Th US govrnmnt pays

if th patint has no insuranc or if h

is ovr 65 via our Mdicar systm for

th ldrly. For all othrs btwn:

Fact File: The annual US influenza summit

The US National Influenza Vaccine Summit (NIVS) started with 30 people 11 years ago and now has 160 participants

and many organizations, said Litjen Tan, NIVS co-chair.

The membership of NIVS includes a huge diversity of stakeholders: from vaccine manufacturers and distributors,

federal agencies and professional medical entities to hospitals to employers, consumers and advocacy groups 130

in all. This allows a full 360-degree view of all the moving parts in the US associated with flu immunisation, he said.

Aside from its educational activities, NIVS also organises regular communications between its stakeholders via

meetings, email updates and weekly conference calls. This kind of face-to-face meeting, with all partners present,provides a safe venue to raise issues and to discuss potential solutions honestly, he said.

privat insuranc foots th bill. This

poss som cost challngs sinc, for

instanc, suprmarkt vaccinations ar

basd on a cash-out-of-pockt pric of

around $25. This is don via a standing

ordr of th GP not via a prscription.

Q: What is your main challenge for this

coming year?

Tan: Maintaining th gains wv

alrady achivd. Th ovrall vaccination

covrag among adults with risk

conditions is about 35 prcnt and in

that rgard w havnt don as wll as

europ. Boosting vaccination covrag

among HCs in long-trm halth car

cntrs is anothr ky goal for us.

Q: What were the more noticeable

effects of the US governments universal

vaccination recommendation?

Tan: ll, it surly had somthing to do

with th ris in child vaccination from 29

prcnt for 2008/09 to around 50 prcnt

in 2010/11. Also, th vaccination rats for

prgnant womn ros dramatically from

6-19 prcnt to 49 prcnt in 2010/11.

Ths rsults wr dlightful for us.

Place of vaccination,persons aged 65 years,

United States,March 2011

Sourc: National Flu Survys,

March 2011, CC unpublishd data

thr non-mdical plac School orkplac Pharmacy / drug stor /

suprmarkt / suprstor

thr mdically-rlatdplac

Halth dpartmnt Clinic / halth cntr octor's offic

5% 1%4%

26%

2%2%

20%

40%


24/284

hil in gnral th public do nottrust th mdia, paradoxically it

ovrwhlmingly rlis on th mdia as

its main sourc for information and

th pandmic was drivn by th mdia,

Nubrt told th eSI summit.

H said it was imprativ that th

mdical world undrstand vn if it

dosnt accpt th rol that hyp plays

in th mdia. Journalists hav to us

xaggration just to satisfy thir ditorsand thir organisations ban-countrs

[accountants and financial officrs] so

that a story will sll, said Nubrt.

Thr obstacls stand in th way of

good scintific and mdical rporting,

according to Nubrt:

th commrcial natur of journalism

th low broadcast prim-tim priority

assignd by ditors to scintific topics

th intrnal pcking ordr of mdia

organisations

Th biggst obstacl is an ditorsranking of nws topics for covrag.

Halth topics may b of utmost intrst

to th public, but at th sam tim its

intrst in gnral scinc coms only

aftr sports, ntrtainmnt and politics

in that ordr. Unfortunatly, scinc

is simply not prim-tim foddr,

obsrvd Nubrt. Also, it is hard for a

journalist to rport on uncrtaintis: you

cant convinc popl that pandmic flu

is a major thrat whn most hav notxprincd it.

Anothr major factor that runs against

good scintific rporting in th prss is

th pcking ordr or intrnal hirarchy

of mdia organizations.

nc a halth-rlatd topic such as

influnza pandmic riss to a crtain

conomic or political lvl, it is takn

away from th spcialisd journalists

who know th subjct, h said. It

thn gts handd ovr to th prssorganisations star rportr and this

is whr th mistaks bgin: ths ar

journalists who dont first chck thir

storis with th othr rportrs who

know th subjct.

Finally, Nubrt said thr wr limits

to how much information th individual

can procss in an ra of information

ovrload.

Though h insistd that mdical

rporting by mass mdia has improvd

in th last 20 yars, h qustiond

whthr this has ld to mor mdical

litracy across th population in

gnral. hil th lvl of th publics

uptak of mdical information is still

an opn qustion, on thing is crtain:

scinc is progrssing fastr than th

mdia can rport on it and fastr than

popl can undrstand it, h said.

How should influenza scientists and industr deal with the media during a major

public health incident when even the most objective medical facts can be ignored

or distorted b journalists looking to exaggerate a stor beond its legitimate

news value? Can the flu research communit ameliorate this situation or is itcondemned to live with the vagaries of the press?

The 2009 pandemic was one example of how ill-informed news reporting can

stoke a health panic or create a backlash against authoritative medical voices,

according to Hanns-Joachim Neubert, president of the European Union of

Science Journalists Associations.

MEDIA, MEDICINE & THE PUBLIC:A LOE-HATE AFFAIR


25/2825


B U S S e L S , 2 6 M A Y 2 0 1 1

Self-interest: media have to come

clean, too

Nubrt was critical of europspharmacutical industry for using

what h calld non-transparnt

communications tchniqus such as

advrtorials.

Ths look lik ral articls, but which

carry no industry nam abov thm.

Th public cannot s th diffrnc

btwn srious portals and factual

ons usd by som companis for

vry aggrssiv but non-transparnt

markting, dclard Nubrt. Srious

scinc journalists hav larnd to b

vry suspicious about thm.

Svral mmbrs of th audinc took

issu with that point of viw. n industry

official countrd: I tak xcption towhat you say about industry. Vaccin

manufacturrs wr vry carful during

th pandmic to str clar of any

commnts about public policy or how

to manag th pandmic. focusd

on manufacturing th vaccins and

antivirals, and that was that: industry

cam out clan on this.

hras scintists ar traind to list

potntial conflicts of intrst, Nubrt

admittd that for journalists a story

has to b sold to somon. For public-

ownd channls, this is not an issu.

But for th pay-TV, its tru you hav

to hyp things to gt thm pickd

up.Ultimatly, h said th bst scincrporting flows from authoritativ

sourcs whom th rportr fls h

can trust. I hav about 50 contacts

who I trust but it rquirs tim to build

this up. You cannot do it with a singl

prss confrnc. Mdical scintists

nd to do th sam thing: build thos

rlationships with th prss basd on

trust. Thn you can sll your mssag,

h said.

Damage Control: Tips for Dealing with the Press

According to German science editor Hanns-Joachim Neubert, the best way for the influenza research community to

avoid getting burned by the press is to stick to some basic guidelines. These call on stakeholders to:

be precise and open about their research results and the latters funding background information: who paid for it?

pre-identify the media that you want to target

pay close attention to the way the journalist summarises your answers to his questions accept that journalists need to be critical but that they can be your partner, too if the trust is there.


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SUMMITCNCLUSINS


27/2827


B U S S e L S , 2 6 M A Y 2 0 1 1

In 2003, the World Health Organization (WHO) launched its vaccination

recommendations for seasonal influenza, urging ever Member State to annuall

immunize at least 75% of its senior citizens against influenza b 2010. In 2011,

most of the European countries do not even come close to the WHO recommended

vaccination rates, despite European health care sstems being amongst the best

in the world. In fact, influenza still claims more lives than traffic accidents,

especiall among the risk groups, which include the elderl and patients with

chronic disease like asthma, COPD, diabetes, heart disease

While EU countries are lagging behind Northern American countries such as

Canada, the influenza partners at the European Influenza Summit (including

international public health authorities like WHO and the EU Directorate-General

for Health and Consumers) agreed that onl b ensuring collaboration between

all parties involved in the field of influenza, Europe will be able to lower the

impact of the disease on public health. Illustrating the need of joining forces in

a decisive partnership, WHO and EU representatives emphasized the importance

of exploring was to involve additional healthcare groups in the fight against

influenza.

ESWI had anticipated this call b bringing together health professionals like

hospital pharmacists, general practitioners, communit pharmacists and

hospital managers as well as organizations of the elderl, diabetes patients,

respirator disease patients and heart patients in a uniue and fruitful meeting

on 26 Ma 2011. And while the European Scientific Working group on Influenza

had alread been working with public health officials and polic makers on

previous occasions (such as the ESWI Influenza Workshops for Public Health

Officials and the ESWI Influenza Conferences), it more recentl also has been

establishing close working relationships and structural ties with most of the

above stakeholder organizations. Hence, ESWI has now become a true networkof collaborating partners, covering the broad field of influenza.

In the post-summit period, ESWI will continue to expand its network of influenza

stakeholders and to intensif its communication and awareness raising efforts

with them. The European Influenza Summit will be the annual pinnacle of this

partnership collaboration.

On behalf of ESWIs Board of Directors,

Prof Ab Osterhaus

ESWI chair


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