Title: Mathematical & Economic Modelling for Vaccination and Immunisation Evaluation, and Emergency Response
Funder: Department of Health and Social Care

Abstract: Predictive mathematical models and health economic evaluation have a vital role to play in the advice received from JCVI (the Joint Committee on Vaccination and Immunisation) about changes to the UK s vaccination policy. Given the prominence of JCVI, this advice often influences worldwide policies through National Immunization Technical Advisory Groups (NITAGs). It is therefore vital that JCVI is provided with the best quantitative assessments for any decision. Following the advice of the Macpherson review, we believe it is important that JCVI has at least two sets of predictions to increase its confidence in modelling results. Our research has been instrumental in providing additional independent predictions and enabling JCVI to follow this acknowledged best practice. This project will build upon our experience of the past five years in offering the type of health economic predictions that JCVI needs to provide policy advice and recommendations to the government. These predictions are based on the results of (often) complex mathematical models that have been carefully matched to a range of epidemiological and demographic data; the models are used to predict the health changes, and associated health and broader costs, associated with any change to the vaccine schedule. Patient and Public Involvement (PPI) is a fundamental part of our bid, building on the expertise in Warwick, which has developed a framework for linking complex mathematical prediction with PPI, in a manner that is highly informative. The Warwick framework for managing complex data will guide the patient and public involvement in this study, and contribute to its further refinement and enhanced utility for policy makers. The precise work-plan will evolve through careful and regular discussion with GPHAB (Global and Public Health Analytical Branch, Department of Health and Social Care), JCVI and PHE (Public Health England); such that we provide timely advice that helps to support the work of PHE. We will also be responsive to emergency planning, providing rapid predictions and forecasts to emerging outbreaks worldwide, as requested. The project will have a multi-stage dissemination process. Regular reports on progress will be presented to GPHAB as part of our planned meetings; these will also be shared with PHE to minimise later discrepancies and promote the use of current data sources. Final reports on each vaccine evaluation will be shared with JCVI in a timely manner, and work will be published in peer-reviewed journals to both increase the reach of the research and as an extra level of validation.

Lay abstract: In the UK, the main body responsible for recommending decisions to government policy-makers about vaccinations is the JCVI (Joint Committee on Vaccination and Immunisation). Given the prominence and respect given to the JCVI, its advice often also influences policies worldwide. In order for the JCVI to make the best possible decisions about continuing or changing vaccinations, it is important for them to receive two independent sets of forecasts/predictions, with one usually developed by Public Health England (PHE). Our aim is to provide a secondary set of predictions to support the work of JCVI in its decision making, building upon our experience of preforming a similar role for the past five years. Our predictions are based on the results of (often) complex mathematical models that have been carefully fitted to a range of disease and population data. Our models aim to predict changes in health (such as the amount of disease displayed in the UK population) and changes in treatment and other costs associated with any variation in vaccines schedules. Our precise work-plan will be led by demand from the JCVI so that our predictions are synchronised with their need to make recommendations. We will also be responsive to emergency planning, providing rapid predictions and forecasts to emerging outbreaks worldwide (such as recent outbreaks of Zika or Ebola), as requested. Our on-going predictive modelling involves strong public input; our public/patient advisory group meets four times per year and has helped to shape our thinking and test our assumptions. This group comprises of 12 members of the public, drawn from different backgrounds. We anticipate building on this group and expertise going forward. We are already developing a framework to guide the patient and public involvement in modelling studies, and this project will contribute to its further refinement and enhanced value for policy makers The project will have a multi-stage process to communicate our findings to all relevant groups. Regular reports on progress will be presented to the Department of Health as part of our planned face-to-face meetings. Presentations will be delivered at JCVI and JCVI subgroup meetings, together with more detailed written summaries. We will also publish our findings in peer-reviewed scientific and medical journals; this will ensure a wider impact for our results beyond the UK context, but will also involve an additional level of scientific scrutiny. Finally we will make ourselves available for discussions with a range of policy-makers and patient-groups. The successful conclusion of this work will mean that the JCVI can confidently offer robust advice to the UK government, such that limited health resources are spent to have the maximum impact.

Research activity codes: 3.4 VACCINES
Health categories: GENERIC HEALTH RELEVANCE