vaccination · • the next decade offers an opportunity to unleash the uk’s potential to be a...

VacciNationA vision for UK immunisation

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PP-VAC-GBR-1564 | August 2020


2020 has sharpened our focus on vaccination in unprecedented ways. We now look ahead and consider the importance of vaccines in protecting our society against future threats.


Create the right policy environment now and we have an opportunity to truly rebalance healthcare towards prevention, maximising our years of good health, creating a sustainable NHS and supporting a thriving economy.

This document sets out three “big ideas” capturing Pfizer’s clear and ambitious vision for vaccination in the UK. We believe that with continued partnership and collaboration across all parts of the healthcare system, we can harness the possibilities of modern vaccination for the benefit of all and put the UK firmly at the forefront of vaccine research and innovation.

• The next decade offers an opportunity to unleash the UK’s potential to be a global leader in vaccination.

• Vaccination is the bedrock of prevention and good health at all stages of life and should be treated with equal importance across a lifetime. It is an essential way of protecting the nation’s health and that of the UK economy.

• Vaccination can be effective in tackling deeply ingrained health inequalities for communities at greater risk of poorer health now and in the future.

• The COVID-19 response has demonstrated the benefits of collaboration between global life sciences companies, national governments, healthcare systems and regulators, to develop collectively the vaccines of the future.

• The UK has a proud history of vaccination discovery. Research and development is focused on discovering vaccines against diseases we currently cannot prevent and on improving the efficacy of vaccines, for example in pneumococcal disease.

• We can deliver breakthroughs that change people’s lives by closing the gap between the research and development of new vaccines, their rapid adoption, as well as by improving uptake.

• Through collaboration, the life sciences industry and healthcare system can deliver an ambitious long-term strategy for vaccination that will boost the health and wealth of the nation and ensure that the UK is better equipped to address future threats from infectious disease.

PP-VAC-GBR-1564 | August 2020 PP-VAC-GBR-1564 | August 2020

Executive Summary

2020, a turning point for vaccination

The UK Government has committed to delivering a new ten-year vaccination strategy for England1. We believe this is an opportunity to set a world-leading vision for vaccination, matching groundbreaking scientific discoveries with rapid access to vaccines that save lives. The strategy presents an opportunity for the whole of the UK to lead the world in vaccines policy.

To deliver on this, the strategy should:

Maximise the value that vaccination can deliver to the nation’s health and the UK economy

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Unleash the potential of vaccination across society to tackle major health challenges, regardless of age

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03 Make vaccination a priority across the NHS

Implementing an ambitious strategy focused on these outcomes will support delivery of significant improvements to both the health and wealth of the nation. As we set out ambitions for prevention over the next decade, the UK must prioritise vaccination and build resilience to the threat from infectious disease.


Maximise the value that vaccination can deliver to the nation’s health and UK economy

01Whilst it is readily accepted that reducing the rate of infectious disease improves the nation’s health,the significant savings to the UK economy are overlooked as successful immunisation programmescan confer economic benefits to society2. It is widely accepted that prevention is better than cure,and yet 60% of the UK’s public funding for healthcare is spent on cure and rehabilitation, with only 5% dedicated to prevention. This means we are spending £97 billion a year on treating diseases and only £8 billion on preventing them3.


In order to maximise the benefits that vaccination can deliver to the nation’s health and to the economy, we should prioritise:

Rebalancing towards prevention

The value of health predominantly focuses on the treatment of illness, relying on the biological treatment of disease, often overlooking the value and impact of prevention. Prevention and management of infection is the responsibility of everyone working in health and social care and an integral element of patient safety programmes. This applies to all health and social care organisations, regardless of the patient setting or care provider4. Vaccines are among the most successful and cost-effective public health tools for preventing diseases5. The impact can be measured not just in terms of public health but also in economic terms: reducing healthcare costs, decreasing lost labour force productivity, contributing to social and economic development6 and educational performance5. It is time to make genuine progress on refocusing the system towards preventative care7.

Modernising the methodology for assessing the socio-economic value of vaccines

Vaccination plays an important role in maintaining the health of the population. It represents important social and economic returns that go far beyond the individual person or family8. Improving access to vaccination is instrumental in tackling persistent health inequalities for vulnerable communities9. However current methods of vaccine assessment are narrow and offer only a partial understanding of the impact of vaccines10. There are missed opportunities for the UK to realise the full value that vaccination can bring.

As a first step to unlocking this potential, academia and the life sciences sector should collaborate in undertaking a comprehensive assessment of the long-term socio-economic impact of vaccination, e.g. the effects of infectious disease on the UK’s workforce and productivity, and the implications for social care and the prevention of antimicrobial resistance. This means moving towards a reformed system, which considers health effects and societal impact. A fuller understanding of the socio-economic impact of vaccination can also enable greater targeting to tackle entrenched inequalities far more effectively in the future11.

Continuing investment in world-leading scientific research and development

Increased investment in vaccines to maintain the UK’s place at the forefront of research and development means maintaining existing funding streams and, potentially, creating new ones. We should ensure continued access to international funding and keep an open door for talent from all over the world. The Government’s Industrial Strategy has recognised the heritage and importance of UK science in vaccine innovation12. It has also made clear the importance of investment in building further domestic capacity for research and development and manufacturing12.


Unleash the potential of vaccination across society to tackle major health challenges, regardless of age

02Vaccination may offer untapped opportunities to increase the years of healthy life we enjoy. By preventing hospital admissions from pneumonia13 or slowing the march of drug resistant infections14, improving vaccination rates for adults can support improved health as societies age, while sustaining the future of the NHS15. The UK has high rates of vaccination, but we can’t afford to rest on our laurels1. Beneath the headline statistics, the fragility of our vaccination shield is undermined by misinformation and complacency, with some people affected more than others. There is a need to take action to tackle broad health inequalities16 and equip individuals with the right information, as well as easy, convenient access to improve uptake of all recommended vaccinations across society17.


To unleash the potential of vaccination across society to tackle major challenges, regardless of age:

Establish a national leadership forum

The current vaccination programme is confronted with complex demands. Despite several, recent healthcare reforms18, accountability and responsibility for vaccination have become blurred19, slowing efforts to tackle the recent drop in uptake. Vaccines that protect us against flu, human papillomavirus and shingles, to name a few, are making a difference now20,21,22 and there are further scientific advances in the vaccines pipeline23. The need to close the gap between the research and development of new vaccines, their rapid adoption, as well as improving uptake, has never been stronger.

A national leadership forum, as has been created for cardiovascular disease24, may help to close this gap. Supporting the increased focus on immunisation at NHS England, Public Health England and the Department of Health & Social Care, the leadership forum could facilitate greater cross-sector collaboration on the implementation of and accountability for the delivery of the Government’s forthcoming ten-year vaccination strategy.

To ensure timely and effective access to the vaccines of the future, innovation must also be matched by an updated access pathway and early engagement with the life sciences sector. The forum should consider a life sciences working group focused on modernising the access pathway, reducing the time between vaccines development and adoption. The forum, including an individual with responsibility for national leadership (Vaccines Tsar), would help the NHS to embed vaccination in disease pathways as the norm, not the exception, and in response to the threat of vaccine-preventable diseases and antimicrobial resistance.

Publication notes | February 2020

Establish a duty to check vaccination status for all recommended groups

Requiring healthcare providers to encourage uptake of vaccinations is a significant opportunity to improve public health25. NHS England should harness the power of data to support this goal and consider investing in a national, enhanced life course Immunisation Information System26. Using the power of data, we can develop an individual record of vaccination across a person’s life span, available as a digital hand-held app to equip all individuals with their health data and information as an extension of the highly effective “red book” for childhood vaccinations27.

Technology can also improve the sharing of patient records between different healthcare providers from hospital doctors to GPs and community pharmacists so that they have easy access to individual vaccination records.

Value of Vaccines, regardless of age - public and HCP focused national campaign

Renewed focus on prevention offers an exciting opportunity to deliver meaningful advancements in community health. Increased vaccine hesitancy and related misinformation online28 means that engagement strategies must be more responsive and engaging with communities as part of any strategy to modernise access to vaccination. We need to work collectively with the public to support individuals in managing their health with awareness campaigns and clear information. Consistency of messaging is important and the role of healthcare professionals, as well as teachers and parents, in any public information campaign will be pivotal in fighting the growth in misinformation and hesitancy25.


Make vaccination a priority across the NHS

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To meet the demands of a growing and ageing population, the NHS must embed vaccination as part of a seamless model of health for future generations from infancy through to adulthood and into older age. Vaccination provides cost-effective protection for children29 against a host of diseases but remains an underused public health strategy in adults17 who are often among those most vulnerable to vaccine-preventable diseases9. We should seize the opportunity of adult vaccination to support people to live healthier lives for longer and to reduce the strain on NHS resources.


the NHS must embed vaccination as part of a seamless model of health for future generations

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In order to make vaccination a priority for the NHS, we should find ways to:Create new targets for adult vaccination

Develop an annual action plan with clear targets for adult vaccination, putting them on a par with childhood vaccinations. It should set out how vaccination policy and delivery is aligned across priorities set out in the NHS Long-Term Plan30, Public Health England’s Infectious Diseases Strategy31, the Five-Year National Action Plan for (Antimicrobial Resistance) AMR32 and Public Health England’s Five Year Strategy33.

Foster innovation to support better access to vaccination

Access to vaccination is a problem. Challenges in timing, availability and location of services are cited as barriers for many people9. The NHS should consider opportunities to level up access to vaccination through increased use of alternative providers, such as community pharmacy1. Novel models for maintaining routine immunisations during the COVID-19 pandemic should be evaluated and locked in where appropriate and local prevention leaders must also be equipped with the data and resources to improve access and uptake in their area17.

Address unintended system barriers

For many recommended vaccines, delivery can be complicated by confusion over payment and we need greater consistency and alignment19. The interim findings of the Vaccinations and Immunisations Review1 and the Government’s prevention strategy3 offer opportunities to deliver coordinated incentives and reimbursement to support increased uptake of all recommended vaccinations.

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COVID-19Vaccination is an essential foundation of prevention and good health34. The COVID-19 pandemic has demonstrated the importance of immunisation to society. The outbreak and response from governments and the life sciences industry around the world has highlighted the importance of all organisations across the health and care system and wider society coming together to tackle the virus.

PP-VAC-GBR-1508 | June 2020

Pfizer responded to the outbreak with a global five-point plan35:

Marshalling our people: Creating a SWAT team of our leading virologists, biologists, chemists, clinicians, epidemiologists, vaccine experts, pharmaceutical scientists and other key experts to focus on addressing this pandemic.

Sharing tools and insights:Making the vital tools, such as models and tests, available on an open-source platform to the broader scientific community and sharing the data and learnings gained with other companies in real time to rapidly advance therapies and vaccines to patients.

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Applying our drug development expertise: Sharing our clinical development and regulatory expertise to support the most promising therapies biotech companies and others are bringing forward as solutions.

Offering our manufacturing capabilities: Committing to using any excess manufacturing capacity to rapidly get these life-saving breakthroughs into the hands of patients as quickly as possible.

Improving future rapid response: To address future global health threats, Pfizer is reaching out to federal agencies, including the National Institutes of Health, the National Institute of Allergy and Infectious Diseases and the Centers for Disease Control and Prevention, to build a cross-industry rapid response team of scientists, clinicians and technicians able to move into action immediately when future epidemics surface.

As we enter a new era of vaccine innovation it will be important that all parts of the life sciences industry and healthcare system continue to work together to realise the full benefit of vaccination for the UK, with a clear and ambitious vision for the future.


COVID-19 has presented the greatest public health emergency in a generation. The response has demonstrated the importance of all parts of the health and care system working in close collaboration to tackle the virus directly and to try to develop a solution to contain and mitigate its impact in the future.

The pandemic has shown the importance of vaccination to global public health and with a long-term national strategy, the UK Government can seize the opportunity to set a trajectory for a world-leading immunisation policy agenda. An agenda that increases investment in science, tackles barriers to access across the country, unleashes the potential of vaccination at all stages of life and ensures vaccines are a priority within the NHS.

Pfizer’s long heritage in vaccine development36 is coupled with a desire to support the development of a sustainable model of health for future generations. Ensuring the long-term sustainability of our existing immunisation programme will require us to think differently about prevention and have the confidence to try new things in preparing for the world of tomorrow. The scale of the task ahead is significant and strong partnerships will be essential if we are to succeed.

Pfizer has drawn on its experience in this field to present 3 “big ideas”.

Conclusion 1 European Commission press release 12th 1 NHS. Interim findings of the Vaccinations and Immunisations Review – September 2019. Available at: https://www.england.nhs.uk/wp-content/uploads/2019/10/interim-findings-of-the-vaccinationsand-immunisations-review-2019.pdf. [Last accessed June 2020]2 Quilici S, Smith R, et al. Role of vaccination in economic growth. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4802686/ [Last accessed June 2020]3 DHSC. Prevention is better than cure: Our vision to help you live well for longer. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/753688/Prevention_is_better_than_cure_5-11.pdf. [Last accessed June 2020]4 RCN. Essential practice for infection: Prevention and control guidance for nursing staff. Available at: https://www.rcn.org.uk/professional-development/publications/pub-005940. [Last accessed June2020]5 GAVI. Value of vaccination. Available at: https://www.gavi.org/vaccineswork/value-vaccination. [Last accessed June 2020]6 Remy V, Largeron N, et al. The economic value of vaccination: Why prevention is wealth. Journal of Market Access & Health Policy 2015, 3: 292847 House of Lords. The long-term sustainability of the NHS and adult social care. Available at: https://publications.parliament.uk/pa/ld201617/ldselect/ldnhssus/151/151.pdf. [Last accessed June2020]8 WHO. Societal benefits of vaccination. Available at: http://www.euro.who.int/__data/assets/pdf_file/0009/339624/Sociatal-benefits.pdf?ua=1. [Last accessed June 202]9 RSPH. Moving the needle. Available at:https://www.rsph.org.uk/uploads/assets/uploaded/9bdd64f9-6b9e-4d93-86561ce4598bc49e.pdf.[Last accessed June 2020]10 Wei C, Jarrett J, et al. Are vaccines getting a fair deal? Health technology assessment of vaccinesacross Europe. Available at: https://www.sciencedirect.com/science/article/pii/S1098301515036219?via%3Dihub. [Last accessed June 2020]11 Postma MJ, Carroll S, et al. The societal role of lifelong vaccination. Available at:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4802691/. [Last accessed June 2020]12 Government press release. Available at: https://www.gov.uk/government/news/industrial-strategy-delivers-new-vaccines-manufacturing-centre-to-lead-the-fight-against-deadly-disease. [Last accessedJune 2020]13 Shiri T, McCarthy ND, et al. The impact of childhood pneumococcal vaccination on hospital admissions in England: a whole population observational study. Available at: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4119-8. [Last accessed June 2020]14 Jansen KU, Anderson AS, et al. The role of vaccines in fighting antimicrobial resistance (AMR). Available at: https://pubmed.ncbi.nlm.nih.gov/29787323/. [Last accessed June 2020]15 Journal of Market Access & Health Policy. Role of vaccination in the sustainability of healthcare. Systems. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4802702/ [Last accessed July 2020]16 Institute of Health Equity. Health equity in England: The Marmot Review 10 years on. Available at: https://www.health.org.uk/sites/default/files/upload/publications/2020/Health%20Equity%20in%20England_The%20Marmot%20Review%2010%20Years%20On_full%20report.pdf. [Last accessed June 2020]17 The Health Policy Partnership. Life-course vaccination. Available at: https://www.healthpolicypartnership.com/project/life-course-vaccination/. [Last accessed June2020]18 The King’s Fund. The NHS under the coalition government: Part one: NHS reform. Available at: https://www.kingsfund.org.uk/publications/nhs-under-coalition-government. [Last accessed June2020]

19 Junghans C, Lonergan K, et al. Vaccinations not covered under Section 7a: who pays? Available at: https://bjgp.org/content/68/667/92. [Last accessed June 2020]20 Vaccines Today. Bonus benefits: Flu vaccine does more than protect against influenza. Available at: https://www.vaccinestoday.eu/about-us/who-we-are/. [Last accessed June 2020]21 Brotherton JML. Impact of HPV vaccination: Achievements and future challenges. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465571/. [Last accessed June 2020]22 Amirthalingam G, Andrews N, et al. Evaluation of the effect of the herpes zoster vaccination programme 3 years after its introduction in England: a population-based study. Available at: https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(17)30234-7/fulltext. [Last accessed June 2020]23 ABPI. The future of vaccines: The next decade. Available at: https://www.abpi.org.uk/publications/report-of-an-expert-panel-discussion-on-the-future-of-vaccines-the-next-decade/. [Last accessedJune 2020]24 PHE. The 10-year CVD ambitions for England – one year on. Available at: https://publichealthmatters.blog.gov.uk/2020/02/06/the-10-year-cvd-ambitions-for-england-one-year-on/. [Last accessed June 2020]25 Campbell D. Immunisation and public health: Why we are all in it together. Available at: https://www.independentnurse.co.uk/clinical-article/immunisation-and-public-health-why-we-areall-in-it-together/82272/. [Last accessed June 2020]26 ECDC. Designing and implementing an immunisation information system. Available at: https://www.ecdc.europa.eu/sites/portal/files/documents/designing-implementing-immunisationinformation-system_0.pdf. [Last accessed June 2020]27 E Red Book. Available at: https://www.eredbook.org.uk/. [Last accessed June 2020]28 Godlee F. What should we do about vaccine hesitancy? Available at: https://www.bmj.com/content/365/bmj.l4044.full. [Last accessed June 2020]29 BMA. Childhood immunization. Available at: https://www.bma.org.uk/what-we-do/populationhealth/child-health/childhood-immunisation. [Last accessed June 2020]30 NHS. The NHS Long Term Plan. Available at: https://www.longtermplan.nhs.uk/. [Last accessed June 2020]31 PHE. PHE Infectious Diseases Strategy 2020-2025. Available at: https://www.gov.uk/government/publications/phe-infectious-diseases-strategy. [Last accessed June 2020]32 DHSC. UK 5-year action plan for antimicrobial resistance 2019 to 2024. Available at: https://www.gov.uk/government/publications/uk-5-year-action-plan-for-antimicrobial-resistance-2019-to-2024. [Last accessed June 2020]33 PHE. PHE Strategy 2020 to 2025. Available at: https://www.gov.uk/government/publications/phestrategy-2020-to-2025. [Last accessed June 2020]34 European Commission press release. Available at: https://ec.europa.eu/commission/presscorner/detail/en/IP_19_5536. [Last accessed June 2020]35 Pfizer press release. Available at: https://investors.pfizer.com/investor-news/press-releasedetails/2020/Pfizer-Outlines-Five-Point-Plan-to-Battle-COVID-19/default.aspx. [Last accessed June2020]36 Pfizer. Our therapy areas. Available at: https://www.pfizer.co.uk/our-therapy-areas. Last accessed [June 2020]

References

Maximise the value that vaccination can deliver to the nation’s health and the UK economy01

Unleash the potential of vaccination across society to tackle major health challenges, regardless of age02

03 Make vaccination a priority across the NHS

If we act on them together, as a united, collaborative system, we can support the UK to tackle the challenges faced by the NHS and deliver a new generation of innovative vaccines to support health throughout life.


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