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Clinical Trials undertaken by the Oxford Vaccine Group led to the recommended immunisation of three million UK children during the 2009 H1N1 influenza pandemic. This research was also used to inform World Health Organization (WHO) global policy. The 2009 H1N1 influenza pandemic, or "Swine Flu", was first identified in April 2009 and declared a pandemic by the WHO in June 2009. After acquiring two novel flu vaccines for the 2009 H1N1 influenza virus, the UK government approached the Oxford Vaccine Group to provide paediatric data on the safety of each vaccine. Rapidly recruiting 943 children to the study, the Group delivered essential data to the Department of Health prior to the onset of the winter influenza season. In August 2010, the WHO declared the H1N1 pandemic over.
Research conducted by LSHTM has informed the delivery of a 30-year WHO strategy aimed at reducing the devastating burden of liver cancer in Africa and least developed countries in other regions. Studies evaluating the effectiveness of the Gambia Hepatitis Intervention Study (GHIS) - the only randomised trial of a hepatitis B vaccine with a disease endpoint in Africa - have shaped current WHO policy recommendations for vaccinations against the virus, enabling WHO to advise against the need for a booster programme, and protecting governments in the less developed world from significant additional expenditure.
Research by the Institute of Aquaculture has made a significant contribution to the development of effective fish vaccines, some of which have been commercialised and are used widely within the aquaculture industry. The majority of farmed fish in the UK are vaccinated (44 million salmon and 7.5 million rainbow trout in 2012 alone) with vaccines developed at Stirling, resulting in vast improvements in survival and fish health, and a sustained minimal use in antibiotics through mass vaccination. Vaccines have been developed for all the major farmed species in Europe, and recently the first vaccine for Pangasius catfish in Vietnam (>2 million tonne).
A trial of a pneumococcal conjugate vaccine (PCV) coordinated by Greenwood (LSHTM) and conducted in Gambian infants, showed a significant reduction in invasive pneumococcal disease, severe pneumonia, hospital admissions and deaths in vaccinated children. These results played an important role in encouraging WHO to recommend the introduction of a PCV into the routine immunisation programme of all countries with a high child mortality. Fifty-one GAVI eligible countries have now introduced, or made a commitment to introduce, a PCV into their routine infant immunisation programme with the consequent saving of many young lives.
Rotavirus is the leading cause of acute gastroenteritis in infants and young children worldwide, causing 500,000 deaths annually. Prof Cunliffe at the University of Liverpool (UoL) has conducted rotavirus studies in Malawi since 1997, including descriptive epidemiology and the first clinical trial of a human rotavirus vaccine in Africa. Based upon the results of this clinical trial in Malawi, where vaccination was shown to reduce severe rotavirus disease caused by diverse strains by 50%, a global recommendation for rotavirus vaccine use was issued by WHO in 2009. African countries are now introducing rotavirus vaccines into their childhood immunization schedules with introduction in Malawi in 2012.
Research at LSHTM has been central to the introduction of the Hib vaccine in developing countries. School staff were involved in the 1990s Gambia Hib vaccine trial, which demonstrated the impact of Hib vaccine on pneumonia. Through their work on the subsequent Hib Initiative, their research was instrumental in speeding up evidence-based decision-making for Hib vaccine introduction in a number of countries, mainly in Asia and Africa. The project has been an outstanding success, with Hib vaccine now introduced into 71 of the 73 countries eligible for GAVI Alliance support.
LSHTM researchers have developed four computer models to help decision-makers make evidence-based choices about new vaccines and vaccine schedules. These models analyse the public health impact and cost-effectiveness of different options under different assumptions and scenarios on a country-by-country basis. They are used by national immunisation managers and key decision-makers, international committees and partner organisations (e.g. the Global Alliance for Vaccines and Immunisation and the Bill & Melinda Gates Foundation). LSHTM's researchers have built on this research for WHO, informing global recommendations on vaccine timing and schedules.
Research by Professor Grassly and colleagues at Imperial College on the epidemiology of poliovirus and the efficacy of new vaccines has played a critical role in the thinking and strategy of the Global Polio Eradication Initiative (GPEI). This research has supported the introduction of new vaccines, guided the timing and location of vaccination campaigns and influenced polio `endgame' policy. This is documented in the GPEI Strategic Plan 2010-2012, where Imperial research informed 2 of the 4 `major lessons' concerning poliovirus epidemiology described in the executive summary that led to changes in the programme. The research has also informed our understanding of mucosal immunity induced by oral poliovirus vaccines, and led to two clinical trials of the potential role of inactivated vaccine to boost mucosal immunity. Results from one of these trials were used to support the recent World Health Organisations (WHO) recommendation for universal vaccination with inactivated vaccine following the switch to bivalent oral vaccine in routine programmes.
Since its discovery in the 1980s, avian metapneumovirus (AMPV) has spread in poultry populations worldwide with major adverse health and food security implications for commercial chickens and turkeys. Research at the University of Liverpool (UoL) led to the registration of a live vaccine in 1994 which has played a global role in AMPV control, thereby safeguarding the supply of poultry meat and eggs. Recent research and development at the UoL has identified key control measures, relating to vaccine application, vaccine selection, efficacy and safety, which have had a significant impact on poultry health and consequently, poultry producers and consumers. In particular, demonstration that live AMPV vaccines can revert to virulence, that vaccine type applied influences field protection and that continuous use of a single vaccine can influence circulating field strains, has resulted in UoL leading policy making with regard to current AMPV vaccine protocols.
Viral infections pose a significant risk of long-term disease and death to cats. In Europe alone, over 30 million domestic cats are vaccinated each year against three core pathogenic viruses. Research performed at the University of Glasgow has systematically supported the development of key technologies against major feline viral diseases. This work has delivered incremental but wide-reaching benefits to veterinary healthcare and animal welfare by providing: (i) reagents used in the diagnostic industry; (ii) viral screening services for big cat conservation programmes; (iii) developmental input into the creation of one of the most efficacious and widely used vaccines against feline leukaemia virus; (iv) testing of feline vaccines for efficacy and safety; and (v) development of best practice guidelines and training for veterinary practitioners on feline viruses.