Research team

Expertise

Methods for disease burden, population health impact and health economic evaluation (including health-related quality of life, cost-effectiveness and cost-benefit analyses). Mainly, but not limited to, the field of preventive public health, both method development and applications. This includes also: Mathematical models of inter-host infectious disease transmission. Mathematical models of intra-host infectious disease immunological response mechanisms Both compartmental and individual-based models. Risk perceptions for infectious diseases and ethical aspects of vaccine policy making (including discrete choice experiments). Determinants of health and health production: methods and applications

Preparing for RSV Immunisation and Surveillance in Europe (PROMISE). 01/11/2021 - 30/04/2024

Abstract

RSV causes severe disease in the very young and elderly and results in substantial healthcare costs. In the last 4 years, substantial progress has been made in development of products for active and passive immunization against RSV, with 19 products currently in clinical development. In 2017, we were funded by IMI to set up RESCEU project (Grant Agreement number 116019), which is the single largest consortium currently working on RSV and has addressed several of the key evidence gaps to inform the introduction of an RSV vaccine. However, new gaps in evidence have emerged and many key requirements for the introduction of a novel RSV vaccine into national immunisation programmes (not addressed within RESCEU) remain unmet. PROMISE's vision is to seamlessly build on, exploit, and add value to the significant achievements of RESCEU to prepare for the imminent introduction of an RSV vaccine. Expanding the existing RESCEU network to include 5 new partners, PROMISE comprises of 5 distinct but interconnected work packages (WPs). WP 1 will conduct epidemiological and cost-effectiveness analyses marshalling data from systematic reviews; national and regional disease registries; surveillance programmes and linked routine healthcare datasets. WP2 will foster a consensus and develop an operational plan for expanded coordinated RSV surveillance and reporting activities; post-licensure monitoring and evaluation of products for RSV immunization across Europe. WP3 will initiate new prospective studies to address key gaps in existing knowledge (RSV disease severity scores, asthma in school age children) and assemble biobanks for biomarker validation. WP4 will validate temporally and at mucosal level biomarkers that were identified in RESCEU adopting state of the art technologies. WPs 1-4 will develop high-quality, sustainable, robust data collection systems that link closely with public health/ regulatory bodies/health care providers for informing policy and regulatory processes.

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  • Research Project

VAXINFECTIO-PD _ VAXINFECTIO: Vaccine & Infectious Disease Institute _ PD: Product Development. 01/01/2021 - 31/12/2026

Abstract

VAXINFECTIO-PD is an established Industrial Research Fund (IOF) consortium, well equipped to build an ecosystem offering research, valorisation, innovation and development to answer existing and new challenges in the field of infectious diseases and vaccinology. These domains fall within one of the valorisation domains of the Antwerp University, and the newly established business unit Antwerp Valorisation & Development (AVD) of the UAntwerp. The VAXINFECTIO-PD consortium built up a unique and extensive track record through research, services, spin-off creation and innovative pathways, in generating product concepts/prototypes and research platforms that form the basis of medical innovation. The various core research units have had an important international image in the recent years with publications in leading journals, coordination of several European projects, as well as active presence and involvement in international scientific and policy forums. For the 6-year period the IOF-consortium will further focus on 5 interlinked valorisation avenues, all creating or guaranteeing growth on the parameters P3, P4, P5 and P6: translational vaccination platform for improved and new preventive and therapeutic vaccines, prognostic and diagnostic platforms, core facilities (for cellular vaccines, human challenge studies and biobanks), infectious disease and immune modelling and prediction, and improved vaccine delivery and medical devices through product development.

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  • Research Project

DESCARTES - infectious DisEaSe eConomics and Ai with guaRanTEeS. 01/01/2021 - 31/12/2024

Abstract

In this proposal we focus on challenges regarding infectious diseases such as measles elimination and optimal influenza vaccination and draw motivation from fundamental questions with respect to healthcare prioritisation. Advancements in the fields of epidemic modelling, health economics and multi-agent learning paired with formally-verified guarantees can improve the effectiveness and reliability of the complex decision-making mechanisms needed to answer such questions. This complexity is situated in different aspects: the computational complexity, model structure and the interactions between multiple agents, in combination with multi-criteria objectives. Our consortium establishes a unique combination of leading expertise, which as a team not only will advance each of these fields, but also develops a new, internationally unique, multidisciplinary research line.

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  • Research Project

COIN-B: COntrolled Interruption of Nucleos(t)ide analogue treatment in chronic hepatitis B. 01/01/2021 - 31/12/2024

Abstract

Chronic Hepatitis B Virus infections affect 3.6% of the worldwide population and result in liver related death in over 700000 people annually. Current standard of care, consisting of nucleos(t)ide analogues (NA), efficiently suppress viral replication, prevent liver disease, but do not cure the infection, defined as Hepatitis B surface antigen (HBsAg) loss. Lifelong NA treatment is therefore often required. However, in some patients with long term viral suppression, treatment withdrawal may lead to persistent off-treatment viral control and an upto 40% chance of HBsAg loss after 5 years. Obviously, identifying upfront which patients will benefit from a treatment cessation is of utmost importance. We recently found in a multicenter international study that off-treatment HBsAg loss differs between ethnicities. In the current proposal we aim to prospectively investigate the contribution of ethnicity, host and viral markers to off-treatment viral outcomes. In addition, we will establish the incremental cost effectiveness of treatment withdrawal using real-life health related quality of life questionnaires and queried costs. P: chronic hepatitis B infection, virally suppressed with NA for at least 12 months (HBeAg seroconversion) or 36 months (HBeAg- infection at treatment start), liver fibrosis upto F2 I: antiviral treatment withdrawal C: ethnic background (Caucasian versus non-Caucasian) O: Primary endpoint: viral control (HBV DNA< 2000 IU/mL) at 72 weeks. Secondary endpoint: HBsAg loss

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  • Research Project

Epidemic intelligence to minimize 2019-nCoV's public health, economic and social impact in Europe (EpiPose). 13/03/2020 - 12/04/2023

Abstract

EpiPose aims to provide urgently needed answers about the epidemiological characteristics of 2019-nCoV, the social dynamics of the outbreak, and the related public health preparedness and response to the ongoing epidemic, as well as to assess its economic impact. The consortium consists of 6 partners in 5 countries (BE, NL, UK, CH, IT) who provide complementary expertise in mathematical and statistical modelling of infectious diseases, participatory surveillance systems, living systematic reviews, and health economic analysis and have a strong international public health network. EpiPose aims at a quick delivery of results, according to the following objectives: (1) To collect and share epidemiological data of 2019-nCoV as widely as possible (2) To provide country-specific estimates of key epidemiological parameters (3) To model the expect impact of 2019-nCoV on morbidity and mortality (4) To monitor awareness and behavioural change during the 2019-nCoV epidemic (5) To provide health economic analyses for interventions within the EU (6) To foster the interaction between the scientific community, public health agencies and the public EpiPose aims to make all research data, code, tools and results publicly available and its dissemination plan targets active communication and interaction with policy makers, other scientific groups and the general public. As such, the epidemic intelligence provided by EpiPose will help minimize the 2019-nCoV's public health, economic and social impact.

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  • Research Project

Vaccine & Infectious Diseases Excellence in Antwerp: Infectious disease prevention, control and management in a One Health policy context (VAX-IDEA). 03/07/2019 - 31/12/2023

Abstract

Infectious diseases (ID) and antimicrobial resistance (AMR) pose a continuous and serious threat to humans and animals (One Health). Five research units from the UAntwerpen, with strong international records and collaboration, will continue to jointly capitalize on their ID expertise. EVECO studies distribution, evolution and ecology of pathogens (plague, arenaviruses, …) and wildlife hosts, offering insights for emerging ID management. LMM has established large consortia (COMBACTE, PREPARE) leading to pan-European infrastructures for ID and antimicrobial consumption research. Next to developing rapid diagnostics, LMM investigates AMR mechanisms and pathogen dynamics in vitro, in humans/livestock, and in animal models to study host-immune response (biomarker discovery) and bacterial pathogenicity. LEH performs cutting-edge research on cell-based immunotherapies, in collaboration with the UZA Center for Cell Therapy & Regenerative Medicine. LEH investigates host-immune responses in vaccine trials using multi-parametric flow cytometry and systems biology to discover novel immune correlates of protection in next-generation vaccines. CEV studies the epidemiology of vaccine-preventable diseases and performs state-of-the-art vaccine trials with large national/international networks, including maternal immunization trials and quarantine studies with genetically-modified polioviruses. Given the global need for EID vaccines (Lassa, Ebola, …) , CEV engages in several innovative (non)-human challenge-phase 1-2 studies. CHERMID undertakes methodological and applied research on the intersection between health economics, biomedicine and mathematics. CHERMID is internationally renowned for developing models of dynamic ID processes within and between hosts and integrating these with cutting edge economic models. By integrating these complementary expertises, this COE will address current and future challenges in ID management.

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  • Research Project

RSV impact and cost effectiveness modelling in low- and middle-income countries. 01/11/2017 - 30/09/2023

Abstract

There are few preventive RSV interventions available and these are generally too expensive for widespread use outside of high-income regions. There are additional RSV preventive interventions under development including maternal RSV vaccines to protect infants as well as monoclonal antibody approaches to be given to infants. PATH has developed an RSV impact and cost effectiveness model for RSV interventions. The purpose of this work is to develop another model for comparison purposes.

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  • Research Project

Celluloepidemiology: generating and modeling SARS-COV-2 specific T-cell responses on a population level for more accurate interventions in public health. 01/11/2020 - 31/10/2021

Abstract

Mathematical simulation models have become indispensable tools for forecasting and studying the effectiveness of intervention strategies such as lockdowns and screening during the SARS-CoV-2 pandemic. Estimation of key modeling quantities uses the serological footprint of an infection on the host. However, although depending on the type of assay, SARS-CoV-2 antibody titers were frequently not found in young and/or asymptomatic individuals and were shown to wane after a relatively short period, especially in asymptomatic individuals. In contrast, T-cells have been found in different situations – also without antibodies being present - ranging from convalescent asymptomatic to mild SARS-CoV-2 patients and their household members, thereby indicating that T-cells offer more sensitivity to detect past exposure to SARS-CoV-2 than the detection of antibodies can. In this project, we will gather on a population level T-cell and antibody SARS-CoV-2 specific data from different well-described cohorts including 300 individuals (and 200 household members) who have had proven covid-19 infection > 3 months earlier, 100 general practitioners, 100 hospital workers, 500 randomly selected individuals and 75 pre-covid-era PBMC/sera. This data will be used in comparative simulation models and will lead to a reassessment of several key epidemiological estimates such as herd immunity and the reproduction number R that will significantly inform covid-19 related public health interventions.

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  • Research Project

Een kader voor herhaalde grootschalige burgerwetenschappelijke onderzoeken om beleidsmakers snel te informeren tijdens verschillende stadia van de COVID-19-pandemie. 22/05/2020 - 21/05/2021

Abstract

In order to suppress or mitigate the COVID-19 – or any similar future - pandemic, both speed and broad population engagement are key. This project aims to collect timely information on behavioural change (voluntary or enforced by government), symptoms, workforce participation and telework, postponed treatment for non-COVID-19 related disease, as well as its psychological and social impact. We do this by setting up a large scale weekly online survey, allowing us to study evolutions over time as well as patterns in the large sets of data obtained (thus far 1 in 6 people in Flanders participated in at least one of the 6 survey waves). We use a great diversity of advanced statistical techniques to analyse the data generated, and share our insights directly with policy makers and the general public. This information directly informs policy making and partly feeds into mathematical models predicting the evolution of the pandemic under various scenarios, and can partly also be used to estimate its economic and social impact. Drawing from this experience, for future COVID-19 waves or other pandemics we aim to set up a lasting framework to obtain quickly reliable information that is representative of the general population. We also want to establish a lasting database, that enables researchers of various disciplines to use as study material in years to come.

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  • Research Project

The stride towards health economic evaluation with individual-based models integrating transmission dynamics, stochasticity and uncertainty. 01/10/2019 - 30/09/2022

Abstract

Background – Infectious diseases have substantial impact on society and model-based health economic evaluation has acquired prominence for policy making. Stochastic individual-based models, in which each individual is modelled separately, are highly relevant to capture heterogeneities in social contacts patterns and transmission dynamics. Although they are suitable to predict disease burden and medical costs in detail, they are not fully exploited yet due to model complexity and computational burden. Aim – To improve health economic evaluations with stochastic individual-based disease transmission models while accounting for uncertainty. Methods – To advance from a C++ simulator towards a new platform for health economic evaluation, "rStride" in the widely used R software. This open-source package will integrate high-performant transmission modelling and state-of-the-art uncertainty analysis. Expected results – (1) New and improved individual-based modelling methods on demography and transmission dynamics. (2) Insights on the effect of social mixing assumptions on the estimated burden of disease. (3) The integration of stochastic effects from individual-based transmission models within uncertainty analysis in economic evaluations. (4) Long-term model predictions, including household dynamics, to explore between- and within-host dynamics. All methods will be applied to case studies on Respiratory Syncytial Virus (RSV) and Varicella-Zoster Virus (VZV).

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  • Research Project

Scientific Chair "International Collen-Francqui 2018-2019" (Prof. dr. Philippe De Wals). 01/10/2018 - 31/12/2022

Abstract

Deze Franqui chair is occupied by Prof Philippe De Wals, Professor at the Laval University in Quebec, Canada. The subject is immunisation programs. During his stay he will convene a "Class of Excellence", selected from different universities. At the end of his stay there will be a symposium at UAntwerpen, with collaboration of this "Class of Excellence".

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  • Research Project

Whole Genome Sequencing to streamline TB diagnosis, improve TB surveillance and optimize individualized TB treatment: a pragmatic trial. 01/10/2018 - 30/09/2020

Abstract

Tuberculosis (TB) continues to be an important public health problem with more than 10 million new cases and over 1 million deaths annually. In low burden regions such as Flanders, immigration and drug resistance pose important hurdles to TB control efforts. Due to the challenges in the current diagnostic pathway, patients suffering from drug resistant TB often receive suboptimal treatment in the first months following their diagnosis, which can amplify drug resistance and lead to transmission of drug resistant strains in the community. Whole genome sequencing (WGS) of Mycobacterium tuberculosis as part of routine TB diagnosis is an attractive prospect as WGS rapidly interrogates the entire 4.4 Mbp M. tuberculosis genome. This information would generate the most comprehensive resistance profile for each patient and allow rapid initiation of the most effective and patient-friendly individualized treatment for each person diagnosed with active TB. Furthermore, WGS would not only contribute to diagnostics but also to public health surveillance, as the results of the WGS assay performed for diagnostic purposes will generate phylogenetic data for routine surveillance of transmission events and outbreak detection. Coupling genomic diagnostics and epidemiology would transform the approach to TB control in Flanders towards a 21st century innovative digital disease detection platform and surveillance system. WGS thus has great potential to become the future cornerstone of routine TB diagnosis, care and surveillance in Flanders. We propose to perform a pragmatic multicenter theragnostic trial of WGS of M. tuberculosis to streamline TB diagnosis, improve TB surveillance and optimize individualized treatment of drug resistant TB to improve treatment outcomes. A pragmatic trial undertaken in real-life conditions will generate the data required for policy development, facilitate the translation of results into routine practice and thus contribute to TB control in Flanders.

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  • Research Project

The historical impact of vaccination. 01/01/2018 - 31/05/2018

Abstract

Vaccines are among the most effective public health tools for the prevention and control of infectious diseases, but public confidence in vaccination programs is decreasing. Scientific evidence on the historical impact of vaccination programs can be used for scientific research and advocacy. As main part of this project, a workshop is to be held at UAntwerpen on the historical impact of vaccination, attended by 30 participants from 10 European countries

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    • Research Project

    Update the WHO Guide for standardization of economic evaluations of immunization programmes (WHO Guide) that originally came out in 2009. 01/04/2017 - 31/08/2017

    Abstract

    The 2008 WHO guide for standardization of economic evaluations of immunization programmes was developed to provide guidance to those who conduct or critically appraise economic evaluations of immunization programmes at the local, national, and global levels. The guide was also used to help programme staff assess transparency, completeness, and comparability of economic evaluations that have been conducted for their own country, or for other countries in the region. This project aims to revise and update this WHO guide to align with the current standards of modelling and economic evaluation.

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      • Research Project

      Respiratory Syncytial virus consortium in Europe (RESCEU). 01/01/2017 - 30/09/2022

      Abstract

      Respiratory syncytial virus (RSV) is not well known outside medical circles, yet most people have probably suffered from it in childhood, as it is the most common cause of severe respiratory illness in infants and children worldwide. The elderly and people with weakened immune systems are also vulnerable to RSV infection. While most people's symptoms are mild, it can result in pneumonia and 3.4 million cases annually require hospitalisation. There is no specific treatment or vaccine for RSV. The goal of the RESCEU project is to gather information on the scale of RSV infection in Europe and its economic impacts. It will then use this information to design best practice guidelines to improve the way RSV cases are monitored in Europe, and to shape future vaccination programmes. The team will also gather and analyse patient samples to identify biological markers associated with severe RSV infection. This information could aid in diagnosis and facilitate the development of new treatments and vaccines.

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      • Research Project

      Underlying dimensions of population health: a longitudinal multicountry analysis of health production and health system's efficiency. 01/01/2017 - 31/12/2020

      Abstract

      Health expenditure in wealthy countries (eg Belgium) increased much over the last 50 years. Growth in health care resources and their use (more and better diagnostics, medication, hospitals, nurses and physicians) may often have surpassed economic and population growth. Knowing how different ways of making health care available translated into different levels of population health is key to evaluating health system efficiency. We want to study the interdependencies between numerous potential determinants of health and health outcomes at the population level.

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      • Research Project

      Including uncertainty from transmission-dynamic models in health economic evaluations: applications for rotavirus and typhoid fever vaccination. 01/10/2016 - 01/10/2020

      Abstract

      BACKGROUND: Dynamic models and sensitivity analysis are valued as crucial to inform decision makers on the cost-effectiveness of interventions against infectious diseases. But currently, sensitivity analyses fail to account for the uncertainty from dynamic models, as such overestimating the confidence in the cost-effectiveness estimate and potentially setting wrong priorities for future research. AIM: To include the uncertainty from transmission-dynamic models in health economic evaluations based on these models. METHODS: We will conduct health economic evaluations of vaccination against rotavirus in Belgium and typhoid in low-income countries, based on existing transmission-dynamic models, and will use probabilistic methods to incorporate the estimated uncertainty from the dynamic models. EXPECTED RESULTS: Identification of the factors that are most influential for (1) the cost- effectiveness of rotavirus vaccination in Belgium when accounting for herd immunity and potential serotype replacement, and (2) the cost-effectiveness of implementing the newly developed typhoid vaccine strategies in low-income countries. (3) Software tool that allows for easy re- assessment of cost-effectiveness and future research priorities when new information becomes available. (4) Recommendations on how to apply different types of sensitivity analysis in the context of health economic evaluations based on dynamic disease transmission models.

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      • Research Project

      Etude medico-economique de vaccins : vaccination antipneumococcique des adultes. 29/04/2015 - 15/10/2015

      Abstract

      This project represents a formal research agreement between UA and on the other hand the client. UA provides the client research results mentioned in the title of the project under the conditions as stipulated in this contract.

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        • Research Project

        Use of the 13-valent pneumococcal conjugate vaccine in the elderly: an economic evaluation. 22/01/2015 - 31/03/2016

        Abstract

        This project represents a formal research agreement between UA and on the other hand the client. UA provides the client research results mentioned in the title of the project under the conditions as stipulated in this contract.

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          • Research Project

          ASCID: Antwerp Study Centre for Infectious Diseases. 01/01/2015 - 31/12/2019

          Abstract

          This project represents a research contract awarded by the University of Antwerp. The supervisor provides the Antwerp University research mentioned in the title of the project under the conditions stipulated by the university.

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          • Research Project

          Predicting Immune responses by Modeling immunoSequencing data (PIMS). 01/01/2015 - 31/12/2018

          Abstract

          Vaccine trials study the changes in vaccine-induced antibodies and T-cells and their protective value against natural infection. As such it has been noted that not all vaccines are equally effective and that variability exists between individuals in the magnitude and duration of the immune response after vaccination. We hypothesize that individual-specific genetic characteristics collected in a short time-window after vaccination are sufficient to predict immune responses for a long time period after vaccination. In this project we will recruit 120 individuals: 40 individuals will receive de novo and booster hepatitis B vaccination, 40 individuals will receive a monovalent measles booster vaccine and 40 individuals will receive a combined measles-mumps-rubella booster vaccine. The participants will undergo sampling on different time points (up to one year after vaccination). We will assess the changes in the expression of genes (transcriptomics) in immune-competent cells following vaccination, the individual-specific genetic predisposition for peptide recognition by T-cells (T-cell receptor and major histocompatibility sequencing), and adaptive immune responses (peptide-specific T-cells, antibodies) after vaccination. We will use advanced longitudinal modeling, data mining and machine learning techniques that will allow us to predict T-cell responses by means of the collected individual-specific data over long time periods. Through this project we will set the standard for Next-Generation Vaccinology. Importantly, our results will also be applicable to other fields of research such as therapeutic cancer vaccination and viral immunology.

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            • Research Project

            Individual behaviour and extra-utilitarian ethics in health economic evaluation: an individual-based modelling approach for measles elimination. 01/01/2015 - 31/12/2018

            Abstract

            The overall aim of this project is to develop a framework for model-based economic evaluation in which people's behaviour influences the transmission of infection and vaccine uptake in different parts of the population, and which includes currently ignored ethical considerations. While this framework would be elaborated for infectious diseases with a specific focus on elimination, it will have many basic characteristics, which can be transferred to other areas of public health where risks and risk perceptions are communicable and have behavioural consequences (eg, the spread of obesity, physical exercise, compliance with screening programmes etc).

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              • Research Project

              The development of a quality control instrument for the evaluation of New Medicines Counselling (NMC). 15/05/2014 - 15/01/2015

              Abstract

              This project represents a formal research agreement between UA and on the other hand IFEB. UA provides IFEB research results mentioned in the title of the project under the conditions as stipulated in this contract.

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                • Research Project

                A quantitative analysis of varicella-zoster virus infection: from immunology to epidemiology. 01/10/2013 - 31/07/2015

                Abstract

                It is our goal to conceptualise mathematical models that describe the basic immunology with regard to varicella-zoster virus (VZV) and immunological perturbations caused by VZV at the individual level. Furthermore, at the population based level we will formulate mathematical models describing the transmission of VZV between individuals. Simulations of both withinhuman and between-human dynamics will be based on biological and epidemiological parameters. These parameters will be estimated from our previous studies, and other international studies, as well as this project's experimental study, which is designed to provide major insights in the immunology of latency and reactivation. More specifically, we will longitudinally assess the immune response of about 120 VZV immune persons whose immune systems were recently perturbed for different reasons such as re-exposure to VZV and reactivation of VZV as shingles (Herpes Zoster). In an innovating way we will also perform similar analyses in 30 healthy individuals thereby creating a control group and defining a benchmark for longitudinal variation in immunity. The biological parameters will be implemented in our newly developed mathematical models after thorough statistical analysis. For the first time in this field, we will apply certain advanced statistical techniques (nonlinear mixed and growth mixture models).

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                  • Research Project

                  Identification of genetic factors leading to neurological complications of chickenpox. 31/01/2013 - 30/10/2015

                  Abstract

                  This project represents a formal research agreement between UA and on the other ESPID. UA provides ESPID research results mentioned in the title of the project under the conditions as stipulated in this contract.

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                    • Research Project

                    Improving (cost-) effectiveness analyses of rotavirus vaccination programmes: combining dynamic modelling with in-depth uncertainty analysis. 01/10/2012 - 30/09/2016

                    Abstract

                    Research objectives General research objective - To advance the field of health economics of vaccines with respect to transmission-dynamic modelling and uncertainty analysis. This will be done by applying the most advanced techniques within these two key-areas to the real-world example of rotavirus disease and vaccination. Specific research objective - In particular, the proposed project aims to develop a model which best represents current knowledge on rotavirus infection and vaccination (including herd immunity and genotype replacement), and to determine the uncertainties that influence the most the effectiveness and cost-effectiveness of a universal rotavirus vaccination programme.

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                      • Research Project

                      Quantification of varicella-zoster virus boosting mechanisms with their public health implications for vaccination. 01/01/2012 - 31/12/2014

                      Abstract

                      The general aim is (1) to quantify exogenous boosting by means of an observational longitudinal study, (2) implement this result in newly adapted epidemiological models, (3) assess the population effects of vaccination against VZV and (4) apply this to inform a cost-utility analysis examining vaccination against VZV.

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                        • Research Project

                        Research into the possible association between administration of the vaccine Pandemrix and Guillain-Barre Syndrome (GBS) 15/12/2011 - 14/12/2012

                        Abstract

                        This project represents a formal research agreement between UA and on the other hand FAGG. UA provides FAGG research results mentioned in the title of the project under the conditions as stipulated in this contract.

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                          • Research Project

                          Investigation into the vaccination condition in intussusception during the first year of life. 15/11/2011 - 31/12/2011

                          Abstract

                          This project represents a formal research agreement between UA and on the other hand FAGG. UA provides FAGG research results mentioned in the title of the project under the conditions as stipulated in this contract.

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                            • Research Project

                            A quantitative analysis of varicella-zoster virus infection: from immunology to epidemiology. 01/10/2011 - 30/09/2013

                            Abstract

                            It is our goal to conceptualise mathematical models that describe the basic immunology with regard to varicella-zoster virus (VZV) and immunological perturbations caused by VZV at the individual level. Furthermore, at the population based level we will formulate mathematical models describing the transmission of VZV between individuals. Simulations of both withinhuman and between-human dynamics will be based on biological and epidemiological parameters. These parameters will be estimated from our previous studies, and other international studies, as well as this project's experimental study, which is designed to provide major insights in the immunology of latency and reactivation. More specifically, we will longitudinally assess the immune response of about 120 VZV immune persons whose immune systems were recently perturbed for different reasons such as re-exposure to VZV and reactivation of VZV as shingles (Herpes Zoster). In an innovating way we will also perform similar analyses in 30 healthy individuals thereby creating a control group and defining a benchmark for longitudinal variation in immunity. The biological parameters will be implemented in our newly developed mathematical models after thorough statistical analysis. For the first time in this field, we will apply certain advanced statistical techniques (nonlinear mixed and growth mixture models).

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                              • Research Project

                              Developing and optimizing stochastic individual-based infectious disease simulation models by parallel multicore computing techniques. 01/07/2011 - 30/06/2015

                              Abstract

                              In infectious disease epidemiology, one is strongly interested in predicting the evolution of a newly emerging pathogen or in monitoring the effects of targeted or universal intervention programs on infectious disease spread in a human population. For many of these research questions such as at the initial phase of a pandemic, 'chance' ("stochasticity") and heterogeneity in risks are key determinants on whether or not the infection will spread or mitigation strategies would be effective and cost-effective. Therefore, stochastic individual-based infectious disease models provide a valuable alternative to the hitherto widely applied deterministic compartmental models. Because of the computational complexity associated with the use of individual-based models in large populations, efficient programming techniques need to be developed and implemented to allow uncertainty analysis and meaningful calibration procedures. The central research questions of this project are fourfold: (1) Which is the most computationally efficient way to simulate an emerging infectious disease epidemic by means of a stochastic individual-based model? (2) Which is the most efficient way to conduct uncertainty analysis and calibration procedures in a stochastic individual-based model applied to pandemic influenza? (3) Which are the main factors that would influence the spread of pandemic influenza in Flanders? (4) Given key characteristics of pandemic influenza (scenarios defined in relation to the basic reproduction number, serial interval and morbidity and mortality in various groups of the population), which prevention and control measures are most effective and most cost-effective to mitigate their spread in Flanders? Initially, the model will be applied to Flanders but generic efficient programming is crucial to enable efficient application to other regions in the world and other emerging pathogens.

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                                • Research Project

                                Prioritization of target groups in relation to the vaccination for seasonal influenza - part 2. 15/01/2011 - 31/12/2012

                                Abstract

                                The two research questions are: - What is the impact of vaccinating children for seasonal influenza vaccination? - What is the cost-effectiveness of seasonal influenza vaccination, for each vaccination scenario?

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                                  Efficiency, equity and autonomy: the ethics of vaccination policy. 01/01/2011 - 31/12/2014

                                  Abstract

                                  We aim to investigate the ethical justifiability of different vaccine policy options. Vaccines are credited with having saved more lives than any other medical technology. Their distribution is of critical importance to guarantee a fair equality of opportunity to everyone. We distinguish three different but possibly conflicting ethical values that constitute just vaccination programs: efficiency, equity and autonomy. Cost-effective vaccines must guarantee as much health as possible given the budget constraint. However the distribution of the financial and medical burdens and benefits of vaccination programs in a population should also be equitable. Since the burdens and benefits of vaccination do not remain limited to the vaccinated person, distributive justice is more complex to determine, compared to other health products and services. Moreover the social dimension of vaccination also creates tension between individual rights and societal duties.

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                                    • Research Project

                                    The role of the different actors in controlling the costs of the medicine use in Belgium. 01/07/2010 - 30/06/2014

                                    Abstract

                                    In the area of production, distribution, payment, prescription and the use of medicines, several protagonists can be identified. Insight into the importance of and in the underlying relationships between these actors, and of the relative impact of these actors on the system as a whole, is necessary. In the European context, little research has been done on this subject. Knowledge on this subject is necessary for the survival of the health care system in Belgium.

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                                      • Research Project

                                      Determination of target groups that should receive priority for seasonal influenza vaccination - part I. 01/01/2010 - 14/09/2010

                                      Abstract

                                      The goal of this study is to make an optimal use of the seasonal influenza vaccines. The main objective is to determine which target groups receive priority for seasonal influenza vaccination based on the health benefit impact and scientific evidence. In addition to the three top priority groups for vaccination, it also wants to assess the benefit and cost of a strategy aiming at reducing disease transmission, by targeting young children.

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                                        • Research Project

                                        Kosteneffectiviteit van 7, 10 en 13-valente pneumokokken conjugaat vaccin 2009-52_HTA. 10/12/2009 - 15/04/2011

                                        Abstract

                                        The aims of this project are to estimate - by means of simulation models - the effectiveness and costeffectiveness of various options of use of licensed 7,10 and 13 valent pneumococcal conjugate vaccines (PCV) vaccines in Belgium, taking account of the Belgian and international experience with these vaccines in terms of efficacy, safety and postlicensure effectiveness. These estimates should include herd immunity effects, serotype replacement effects, and where possible the indirect effects of vaccination on cross protection and antimicrobial resistance.

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                                          • Research Project

                                          Vaccination condition with Rotarix of intussusception during the first year of life. 15/11/2009 - 31/12/2009

                                          Abstract

                                          The aim of this project is to study a potential association between rotavirus vaccination and intussusseption in Belgium.

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                                            • Research Project

                                            VZV vaccination in children and adults aged over 50 years: health technology assessment. 01/06/2009 - 31/03/2012

                                            Abstract

                                            The aims of this project are to estimate - by means of simulation models -the effectiveness and cost-effectiveness of various options of use of VZV vaccines in Belgium, taking account of the international experience with these vaccines in terms of efficacy, safety and post-licensure effectiveness., and the indirect impact of herd immunity.

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                                              • Research Project

                                              Health Economics 01/01/2009 - 31/12/2018

                                              Abstract

                                              This project represents a research contract awarded by the University of Antwerp. The supervisor provides the Antwerp University research mentioned in the title of the project under the conditions stipulated by the university.

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                                                • Research Project

                                                Infectious disease models: wildlife ecology, ecological disturbance and transmission to humans. 01/01/2009 - 31/12/2012

                                                Abstract

                                                Changing environmental conditions (e.g. climate) are likely to affect the ecology of infections, through changes in the abundance of susceptible natural host populations or by affecting transmission rates (directly or through vectors). This project investigates these effects, through observations, experiments and mathematical modelling, for five model infections selected for their different characteristics (hantaviruses in voles, plague in gerbils, arenavirus in African mice, dengue fever in humans, rotaviruses in vaccinated humans). The insights are used to evaluate potential changes in burden of disease, with or without control measures.

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                                                • Research Project

                                                Evaluation of Crisis and Case Management. (ECCAM) 01/10/2008 - 31/07/2010

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                                                  • Research Project

                                                  Health Economics Research and Mathematical Modelling of Infectious Diseases. 01/12/2007 - 31/12/2014

                                                  Abstract

                                                  The research plan over the next years involves four main research themes: 1.1.Modelling infectious diseases; 1.2.Data collection and analysis for burden of (infectious) disease estimates; 1.3.Program evaluations of infectious disease interventions; 1.4.Health economics and program evaluations in general. Each of these research themes departs from the observation that the current methodological approach can be substantially improved by using more sophisticated methods. Since these research themes are each multidisciplinary and interconnected, these improvements are expected to occur within each theme and over all themes combined.

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                                                    • Research Project

                                                    Program Evaluation of universal and targeted options for use of hepatitis A vaccines in Belgium. 01/07/2007 - 01/09/2008

                                                    Abstract

                                                    Worldwide about 1.5 million patients still suffer from hepatitis A every year. The causative agent, the hepatitis A virus (HAV), mainly attacks the liver. Symptoms include fever, nausea, abdominal pain and discomfort, dark urine, pale stools and jaundice (yellow colorisation of the eyes and skin). Illness usually lasts one to three weeks and is almost always followed by complete recovery. Small children who become infected usually have no symptoms or the disease goes undiagnosed. Fulminant cases are very rare and are mostly seen in adults. Vaccines, mainly based on formalin-inactivated viruses produced in cell-culture, have been available on the Belgian market since 1992. These vaccines are well-tolerated and highly-immunogenic. They provide long-lasting protection against hepatitis A infection in children and adults. While no effective treatment is available against hepatitis A infection (other than liver transplantation for rare fulminant cases), vaccination of individuals implemented according to selected strategies at international and national levels, together with improved sanitary conditions, have contributed to a substantial reduction of the (economic) burden associated with disease management. The purpose of the project was to evaluate the effectiveness, utility and cost-effectiveness of possible vaccination strategies for hepatitis A in Belgium, with the aim to make policy recommendations.

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                                                      • Research Project

                                                      Simulation models of infectious disease transmission and control processes (SIMID). 01/03/2007 - 28/02/2011

                                                      Abstract

                                                      The project's aim is to further develop the capacity in infectious disease simulation modelling in Flanders. From a public health perspective, modelling of preventive infectious diseases is far more complex than that of non-infectious diseases, as interventions aimed at infectious disease also heave an impact on people who are not targeted by these interventions. At this moment, there is hardly any expertise available in Flanders in terms of modelling of diseases, whether preventable or not. Therefore, we expect this project to upgrade the expertise in Flanders to an international acceptable level and to improve the overall quality of health economic evaluation capacity as applied in the Belgian context.

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                                                        • Research Project

                                                        Standardization of Economic Evaluations. 01/03/2007 - 31/08/2007

                                                        Abstract

                                                        To draft international guidelines for the World Health Organization on vaccine preventable disease modelling in order to standardize model-based economic evaluation of vaccination.

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                                                          • Research Project

                                                          Contacts between children with chickenpox and varicella-zoster immune adults: an analysis of the post-exposure impact on cellular immunity. 01/01/2007 - 31/12/2008

                                                          Abstract

                                                          Vaccines exist that prevent primary varicella-zoster virus (VZV) infection (i.e. chickenpox) in susceptible persons, and the reactivation of zoster in immune persons. Re-exposure to natural VZV is also considered to be an exogenic boosting mechanism in VZV immune persons. In order to assess the population impact of these vaccines, it is important to document the relative occurrence, duration, and intensity of boosting. This study aims to measure the immunological impact on VZV-immune adults of exposure to a child suffering from primary VZV, by collecting blood samples from adults exposed at a known point in time.

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                                                            • Research Project

                                                            Economic evaluation of rotavirus immunisation of infants in Belgium. 01/12/2006 - 31/05/2007

                                                            Abstract

                                                            In this report, a simulation model was used to help understand the implications of deciding on the use of the currently available oral rotavirus vaccines (Rotarix® and RotaTeq®) to our greatest advantage. In health economic evaluation, as applied in this report, what is to our society's greatest advantage is defined as the combination of interventions leading to the greatest possible health gains, for as many people as possible (i.e. maximization of health gains (expressed here mainly as life years and Quality-Adjusted Life-Years (QALYs gained)), under a given budget constraint. We have reviewed the international published and unpublished literature, and collected and analyzed a wide range of Belgian epidemiological and cost data. A simulation model was developed, parameterized and fitted by using scientifically validated data, as much as possible from Belgian sources. Simulations were performed to estimate how effective and cost-effective universal rotavirus vaccination of Belgian children would be.

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                                                              • Research Project

                                                              Study regarding the introduction of pneumococcal conjugate vaccination in the national infant vaccination program. 02/01/2006 - 30/06/2006

                                                              Abstract

                                                              The aims of this report are to: 1. review the international scientific evidence base relating to the effectiveness and cost-effectiveness and cost-utility of pneumococcal conjugate vaccines 2. document and review the pre-vaccination disease burden of pneumococcal infections in Belgium 3. analyse and compare the effectiveness, cost-effectiveness and cost-utility of feasible options for use of the currently marketed pneumococcal conjugate vaccine in Belgium This report is organised as follows. In section 1, the general background and literature related to the first aim of this report are summarised. Extensive in-depth reviews of the effectiveness and cost-effectiveness of pneumococcal conjugate vaccines are given in appendix A and appendix B, respectively. In section 2, the data and methods for further analyses are presented and discussed. These data serve two purposes: they document aim (2) of the report, and are needed as inputs into the mathematical simulation model we developed to perform an economic evaluation of introducing publicly funded universal childhood pneumococcal conjugate vaccination in Belgium. In section 3, the baseline results and the sensitivity analyses of the economic evaluation are presented. In section 4, some of the more practical policy implications are summarised, including information on pneumococcal conjugate vaccination strategies adopted in other countries, required budget and the current vaccination schedule in Belgium.

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                                                                • Research Project

                                                                Modelling and economic evaluation of rotavirus and HPV vaccination strategies in Australia. 23/03/2005 - 23/03/2006

                                                                Abstract

                                                                This project concerns international collaborative research into the effectiveness and cost-effectiveness of rotavirus and HPV vaccination in Australia

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                                                                  • Research Project

                                                                  Effective and acceptable strategies for the control of SARS and new emerging infections in China and Europe (SARSControl). 01/01/2005 - 31/03/2008

                                                                  Abstract

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                                                                    • Research Project

                                                                    Improving Public Health Policy in Europe through Modelling and Economic Evaluation of Interventions for the Control of Infectious Diseases. (POLYMOD) 01/09/2004 - 31/08/2008

                                                                    Abstract

                                                                    This international EU project aims to optimise the methods for modelling and economic evaluation of interventions for the control of infectious diseases (particularly vaccination). New information on how people mix socially, and how this contributes to the spread of infectious disease in Europe, will be assembled and used optimally in dynamic mathematical simulation models. These techniques will be applied to specific interventions in combination with economic evalauation. The results of these analyses will be made directly available to policy makers in 15 European countries.

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                                                                      • Research Project

                                                                      varicella sero-epidemiology in Flanders. 01/12/2000 - 31/12/2001

                                                                      Abstract

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                                                                        • Research Project

                                                                        Economic evaluation of varicella vaccination of adolescents in Italy and workers in paediatric institutions in France. 16/06/2000 - 31/03/2002

                                                                        Abstract

                                                                        The benefits of universal vaccination against chickenpox have been largely demonstrated in the recent literature. However, due to the potential risk of shifting the infection to older age groups where the disease is associated with severe complications, targeted vaccination may also prove beneficial. The current study uses cost-effectiveness and cost-benefit techniques to explore the efficiency of different vaccination strategies among two risk groups: Italian adolescents (11-years-old) and French workers in paediatric institutions). Health care payer, societal and employer (when relevant) point of views are considered. The strategies investigated are (1) no vaccination, (2) vaccination of the whole risk group , (3) vaccination of those with a negative or an uncertain history of chickenpox, (4) vaccination of those with a negative serological testing for chickenpox and (5) vaccination of those with a negative serological testing performed on those with a negative or an uncertain history of chickenpox. Each strategy is evaluated with the help of simulation models for single ageing cohorts. The validity of the results is explored by varying key variables. The comparability of the results with the existing literature for the adolescents target group only is further discussed.

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                                                                          • Research Project

                                                                          Prevention and control of Hepatitis B in selected countries of CCE and NIS : economic evaluation of universal infant immunisation programmes. 01/12/1998 - 31/05/2002

                                                                          Abstract

                                                                          This project aims to address issues related to the implementation of universal hepatitis B vaccination in selected countries of Central and Eastern Europe and the Newly Independent States. Countries involved in the project are Bulgaria, Russia, Moldova and Uzbekistan. This project will focus on the economic evaluation of this preventive intervention. The main objectives of the project are a) to raise the awareness among health partners, policy makers and health care providers about heaptitis B as a public health problem; b) to summarise available socio-demographic and epidemio-logical data; c) to study the economic efficiency of universal hepatitis B immunisation programmmes; d) to disseminate and promote the findings in formats relevant for policy development and advocacy. To achieve the above objectives, activities will be organised with public health officials, experts and international donors in order to put hepatitis B on the political agenda. These activities will be based on existing epidemiological data and newly generated input. The cost-effectiveness of universal hepatitis B vaccination will be evaluated given the local economic situation in the selected countries and research findings will be disseminated. Training seminars will be organised and publications will be distributed both in English and in Russian.

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                                                                            • Research Project

                                                                            Economic evaluations of hepatitis B vaccination: a global review of recent studies (1993-1999) 16/11/1998 - 31/01/1999

                                                                            Abstract

                                                                            A search was carried out for economic evaluations of hepatitis B vaccination, published between 1993 and 1999. The methodology and results were discussed, according to the level of endemicity. The great majority of these studies were carried out for developed countries, for the most part situated in areas of low hepatitis B endemicity. In countries of very low endemicity economic evaluations have yielded contradictory results. The addition of universal to existing selective vaccination strategies depends on the level of confidence these countries have in their ability to sufficiently identify, reach and fully vaccinate persons in various risk groups. In areas where endemicity is higher (low, intermediate and high) universal vaccination was found to be justified on the basis of cost-effectiveness. More studies seem to be needed to persuade decision makers to include hepatitis B vaccination in routine immunisation programs in countries of high endemicity. The few existing studies for these countries reveal a great economic potential of such programs. In general the accuracy of modeling the spread of infection and the evolution of HBV disease has improved over the years, but still the clarity, completeness and comparability of analyses could improve considerably. Specific guidelines for economic evaluations of the prevention of infectious diseases would be helpful

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                                                                              • Research Project

                                                                              Costs of varicella and cost-effectiveness of varicella vaccination in Belgium. 01/01/1997 - 31/12/1997

                                                                              Abstract

                                                                              By means of a survey, an analysis is made of the evolution of the incidence of varicella in Belgium and the direct and indirect costs associated with varicella. Furthermore a model based economic evaluation is performed of various vaccination strategies against varicella in order to identify the most efficient alternatives.

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                                                                                • Research Project