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UOA05-12: Revolution in influenza vaccine production

Summary of the impact

Research from the University of Oxford has played a major role in the development of effective vaccines to combat the urgent worldwide problem of influenza. This methodology, licensed to AstraZeneca, has been used to prepare the currently licensed live attenuated influenza vaccine FluMist. Since its introduction in 2006 it is estimated that FluMist or other vaccines produced using reverse genetics have saved the lives of thousands of people worldwide who would otherwise have died from flu and its complications. FluMist has generated close to $1 billion income for the manufacturers (MedImmune, owned by AstraZeneca).

Submitting Institution

University of Oxford

Unit of Assessment

Biological Sciences

Summary Impact Type

Technological

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Immunology, Medical Microbiology

Evidence to Inform Policy Formulation for Influenza Pandemic Planning and Response

Summary of the impact

The work of Professor Ferguson and colleagues at Imperial College on modelling the effect of different intervention measures on the spread and health impact of a new influenza pandemic has substantially shaped UK and international public policy-making over the last 7 years. Prior to 2009, this work shaped UK policy on antiviral and pre-pandemic vaccine stockpiling and use, and on the potential use of school closure and border restrictions during a pandemic. During the 2009 H1N1 pandemic, real-time research provided the first estimates of key epidemiological parameters of the new pandemic virus, demonstrating the low-to-moderate severity and lower than typical transmissibility. In the UK, US and other countries, these data informed public policy decisions to pull back from use of economically costly interventions (such as reactive school closure or antiviral prophylaxis) and focus on targeted use of vaccination as the principal pandemic mitigation measure.

Submitting Institution

Imperial College London

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services, Other Medical and Health Sciences

Responding to the threat of pandemic influenza

Summary of the impact

Research carried out by the Health Protection and Influenza Research Group (HPIRG), Division of Epidemiology and Public Health, impacted directly on the UK Government's response to the 2009 influenza pandemic, feeding directly into policy-making decisions. The group was appointed as an official WHO Collaborating Centre for pandemic influenza in 2010 and through its related research has "reduced the economic impact on Member States for pandemic preparedness" (quote from reference 7, section 5). In 2011, it secured £7M funding from the US Centers for Disease Control and Prevention (CDC) to lead `once only' work to determine the modes of influenza transmission using a human challenge model.

Submitting Institution

University of Nottingham

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Informing national and international influenza vaccination policy

Summary of the impact

Research undertaken at UCL's Centre for Infectious Disease Epidemiology has provided evidence about vaccination of different groups against influenza which have influenced policy and practice. In particular, our work underpins the government's ongoing policy on vaccination of healthcare workers, and is cited every year in the Chief Medical Officer's letter to healthcare workers as well as international recommendations on influenza vaccination of healthcare workers, including widespread mandatory vaccination programmes in North America. Research on influenza and acute cardiovascular events has informed US recommendations for prevention of stroke through vaccination. Recent work also informed the decision in the UK to extend regular influenza vaccination to children.

Submitting Institution

University College London

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

UOA01-10: Preventing the Spread of H1N1: Immunisation Trials in UK Children

Summary of the impact

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.

Submitting Institution

University of Oxford

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Immunology, Medical Microbiology

Supporting influenza pandemic preparedness

Summary of the impact

Research conducted by LSHTM into how governments and international organisations are preparing for an influenza pandemic has made an important contribution towards efforts to avoid the risks of up to 150m deaths anticipated by WHO in the event of such a pandemic. Governments, including the UK, and global institutions, have made policy changes and resource allocation decisions directly as a result of this research and technical advice.

Submitting Institution

London School of Hygiene & Tropical Medicine

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services, Other Medical and Health Sciences

Mathematical modelling informing policy on human infectious diseases, particularly pandemic influenza

Summary of the impact

Researchers in the Epidemiology Group at the University of Warwick have an international reputation for high-quality mathematical modelling of human infectious diseases, with particular emphasis on population heterogeneity and variability. Such formulations and insights are an important component of predictive modelling performed by Public Health England (PHE), and are helping to shape national policy for a range of vaccine-preventable infections.

The Warwick group was instrumental in providing a range of real-time analyses and advice to UK authorities during the 2009 H1N1 (swine-flu) pandemic, acknowledged by the Department of Health (DoH) to be "fundamental to the construction of the UK's pandemic response" and making an important contribution to the overall programme which "led to the saving of many hundreds of millions of pounds of taxpayers money, while greatly increasing the health of the Nation". Modelling and analysis carried out at Warwick continue to provide insight into the control and containment of future pandemics and are considered "essential in determining UK pandemic policy".

Submitting Institution

University of Warwick

Unit of Assessment

Mathematical Sciences

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

Improving influenza and pneumococcal vaccination rates in primary care

Summary of the impact

Research by the Community and Health Research Unit (CaHRU) has had broad international and national impact on community-based prevention, influencing influenza and pneumococcal vaccination policy and practice in the UK, North America and Australia, and impacting on general practitioner and primary healthcare. This has led to improvements in influenza vaccination in the elderly aged 65 years and over as well as younger people aged two years and over at risk of influenza and pneumonia, in Lincolnshire, UK and internationally via policy, education and guidance since 1999.

The research has increased public and practitioner awareness of the link between influenza and cardiovascular disease and the potential for influenza vaccination to prevent acute myocardial infarction (AMI) and stroke. It has affected international vaccination policy; through the findings being incorporated into national guidance for general practices and e-learning on how to improve UK influenza vaccination rates. Overall there has been a substantial take-up of our findings and recommendations.

Submitting Institution

University of Lincoln

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Medical Microbiology, Public Health and Health Services

Debunking MMR vaccine associated scares

Summary of the impact

Professor Rima's research on measles and mumps viruses over 4 decades at Queen's University allowed him to play an important role in re-establishing public confidence in the safety of the measles-mumps-rubella (MMR) vaccine. Claims that MMR vaccine could cause autism in 1998 undermined the vaccine uptake but Rima's expert testimony and that of others established in court that these claims were unfounded. This re-assurance and subsequent promotion of MMR vaccination reduced measles cases in the UK. In the USA, it also reduced the real risk that the Vaccine Court Fund, which compensates vaccinees for genuine vaccine related adverse events, would be bankrupted by over 50,000 claims amounting to between $30-50 Billion.

Submitting Institution

Queen's University Belfast

Unit of Assessment

Clinical Medicine

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Immunology, Medical Microbiology

UOA05-11: BEAST and Phylogenetic inference in viral disease epidemiology

Summary of the impact

Research at the University of Oxford into molecular evolution led to the development of BEAST, a powerful suite of computer programs for evolutionary analysis. Viral genome sequences from infected populations can be analysed to infer both viral population history and epidemiological parameters. This approach has been used to track and predict the transmission and evolution of pathogens, particularly viral infections of humans such as influenza and HIV. BEAST was used alongside traditional epidemiological methods by the World Health Organization to rapidly assess and identify the origins of the 2009 H1N1 `Swine Flu' pandemic; immediate recommendations for necessary international action followed. This approach is now widely adopted by health protection agencies and health ministries around the world and is being applied to understand viral diseases of both humans and animals.

Submitting Institution

University of Oxford

Unit of Assessment

Biological Sciences

Summary Impact Type

Health

Research Subject Area(s)

Mathematical Sciences: Statistics
Biological Sciences: Genetics
Medical and Health Sciences: Medical Microbiology

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