Immunisation in a digital world - Futures Workshop

Immunisation in a digital world:
Futures Workshop
Tuesday 26th June 2018
This event is kindly supported by Sanofi
#ImmuTech

Welcome and plan for the
workshop
David Sinclair
Director
ILC-UK
#ImmuTech

The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
Welcome
David Sinclair, International Longevity
Centre – UK @ilcuk @sinclairda

The specialist think tank on
the impact of longevity on
society, and what happens
next.

Our work on vaccination
Working with and speaking at IFA events; Event on Vaccination
and AMR; Immune Response Report; SAATI report; Spoken at
events in London, Brussels, San Francisco, Barcelona etc;
Spoken at Academic (e.g. ECCMID; IAGG) as well as policy (IFA).
Ran vaccine related events at our conference. Worked with UK
and European policy-makers; House of Lords dinners; Worked
with All Party Vaccination Group and ABPI Group in Parliament;
Event in European Parliament; Spoke to DH Vaccine officials in
Australia; Maintained and promoted website; participated in
Florence Geriatric conferences; articles in media (e.g. in the
Guardian). Media stories about our work on vaccination.
Mentioned adult vaccination on BBC Breakfast interview.

Welcome
10:00 Welcome/Plan for the workshop David Sinclair, Director, ILC-UK
Why is adult immunisation important and what do we need to do to increase uptake?
10:10 Speeches and Panel discussion
How might technology help break down the barriers to adult immunisation?
10:50 Speeches and Q&A
Putting ourselves in the shoes of someone who isn’t vaccinated
12:15 Workshop - Why don’t adults get vaccinated
12:35 Lunch
13:05 Plan for the afternoon
How can technology help? Futures Workshop
13:10 Playing Higher or lower, pt. I - Ideas for using
technology
All
13:25 Playing Higher or lower, pt. 2 - Barriers to using
technology
All
13:40 Playing higher or lower, pt. 3 - Policy and practical
solutions to using technology
All
13:55 Feedback “Why don’t adults get vaccinated?” and
“Higher and Lower”
All
Conclusion
14:30 Speeches and reactions
16:00 Close All

What do we want from you today
 Stand up; make coffee; swap groups if you want; tell us what
you think.
 An open mind! Have a look at the posters
– Your ideas of how technology can increase uptake of adult
immunisation
– Your views on the barriers to the use of technology to
increase uptake of adult vaccination
– Your views on the policy change needed
We will publish a final report in the autumn.

David Sinclair
Director
International Longevity Centre - UK
Davidsinclair@ilcuk.org.uk
02073400440
Twitter: @ilcuk and @sinclairda

Why is adult immunisation
important and what do we need to
do to increase uptake?
#ImmuTech

Elena Gentile MEP
Group of the Progressive Alliance of
Socialists and Democrats
Italy
#ImmuTech

Dave Eaton
Policy and Public Affairs Manager
ILC-UK
#ImmuTech

Daphne Holt
Chair
Coalition for Life-Course Immunisation
#ImmuTech

Peggy Maguire
Director General
European Institute of Women’s Health
#ImmuTech

#ImmuTech

Dr Isabel De La Mata Barranco
Principal Adviser for Health and Crisis
Management
DG Sante
#ImmuTech

Q&A
#ImmuTech

How might technology help break
down the barriers to adult
immunisation?
#ImmuTech

How the UK used technology and data
to maximise uptake of vaccination
David Salisbury
Centre on Global Health Security
Chatham House
#ImmuTech

Immunisation in a digital world.
Prof. David Salisbury CB
FRCP FRCPCH FFPH FMedSci
Centre on Global Health Security, Chatham House, London.

Immunisation
data
Process Coverage
Outcome
Sero-
surveillance
Disease
surveillance
Adverse
reactions
Immunisation Performance Indicators

Birth
registration
• Prompt
• Ubiquitous
Physician
registration
• Call / recall
• Rapid upload
Local/Regional
/
National
• Data analysis
• Performance
management
Immunisation coverage data

Influenza vaccination: data for
management

Influenza vaccine uptake for those aged 65 and over and 65 at risk from 2000 to
2001
through to 2017 to 2018 for England. WHO 2010 target is 75%.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/710416/Seasonal_influenza_vaccine_uptake_in_GP_patients_winter_season_2017
_to_2018..pdf

Vaccine uptake in under 65s, by indication for vaccination and age, in 2010-2011
Begum, F. and R. Pebody, Seasonal influenza vaccine uptake amongst GP patient groups in England, Winter season 2010-11, 2011,
Department of Health.

Flu mortality by risk group
Source – HPA: Surveillance of influenza and other respiratory viruses in the UK 2010-2011

Universal
childhood
influenza
vaccination

Impact of vaccination in 2014–2015: summary
• Number needed to prevent by vaccinating children for the whole population impact
– 16 children vaccination will prevent 1 GP ILI consultation
– 317 children vaccination will prevent 1 influenza hospitalisation
– 2205 children vaccination will prevent 1 confirmed influenza ICU/HDU admission.
Primary school pilot areas versus non-pilot areas
39
Age group GP ILI consultations ED respiratory
attendance
Hospital admission ICU/HDU admission
5–10 years -94%
OR 0.06 (0.01 – 0.62)
ARD -247/100,000 popn
-74%
OR 0.26 (0.08 – 0.91)
ARD - 9%
-93%
OR 0.07 (0.01 – 0.55)
ARD -16/100,000 popn
-76%*
OR 0.24 (0.02 to 3.01)
ARD -2/100,000 popn
<5 years -92%*
OR 0.08 (0.01 – 1.02)
ARD -227/100,000 popn
-65%*
OR 0.35 (0.04 – 2.94)
ARD - 16%
-62%*
OR 0.38 (0.11 – 1.32)
ARD -31/100,000 popn
-61%*
OR 0.39 (0.06 to 2.55)
ARD -3/100,000 popn
>17 years -59%
OR 0.41 (0.19 – 0.86)
ARD -289/100,000 popn
-21%*
OR 0.79 (0.37 – 11.66)
ARD - 1%
-34%*
OR 0.66 (0.22 – 11.93)
ARD -14/100,000 popn
-46%*
OR 0.54 (0.25 to 1.16)
ARD -2/100,000 popn
‘bold %’ p<0.05; * Statistically non significant; (%), confidence interval; ARD, absolute risk difference; popn,
population
ED, emergency department, GP, general practitioner, ILI, influenza-like illness, ICU, intensive care unit, HDU, high dependency unit
ADAPTED from Pebody RG et al. Euro Surveill. 2015;20(39):pii=30029.

Immunisation – the intersection.
StrategyPolicy
Informatio
n Systems
Performance
Management

How Big Data can address hurdles
related to vaccination access &
coverage
Michael Greenberg, M.D., MPH
Vice President and Head, Global Medical Strategy
Sanofi Pasteur
#ImmuTech

Addressing vaccination access &
coverage through Big Data
Sources: 1National Diabetes Statistics Report, 2014 (released June 10, 2014) http://www.diabetes.org/diabetes-basics/statistics/?loc=db-slabnav#sthash.GuDGFjln.dpuf. Accessed April 9, 2015 | 2Gregg EW et al. N Engl J Med 2014;370:1514-1523 | 3ational Institute of Diabetes and Kidney Diseases 2009 |
MICRO-VASCULAR
COMPLICATIONS
FOR ENDORSEMENT
Global Medical Strategy, Sanofi Pasteur
Michael Greenberg, MD, MPH

6 Million
48 Million
2 Billion
48
28

Volume
SCALE OF DATA
Variety
DIFFERENT
FORMS OF DATA
Veracity
UNCERTAINTY
OF DATA
Velocity
ANALYSIS OF
STREAMING DATA
Thousands of publications
Flu – 50 million
flu queries weekly
Daily behavior of >57 000
diabetic patients
VAXITREND –
Internal Market Researches
20 countries; 17 000 patients, 3000 HCPs
The
FOUR Vs
Daily Behavior information
Activity trackers
Daily searches
Graphs / Tables
Internet queries & posts
Publications
Lifestyle Trackers
Internal data controls
Data cleaning
GRADE Evaluation:
Evaluate the quality
of medical evidence
Methodological rigor
Why Big Data?

Why Flu & Diabetes?
45
We need deeper understanding to increase flu vaccine coverage
HOSPITALIZATIONMetabolic complication:
Decompensation,
ketoacidosis , deaths
Infection complication
Secondary infection
Influenza vaccination is
recommended (and
funded)
DEATHS
3-6x
6x
Why do people living with
Diabetes do not get vaccinated
(more)?

3-Step pilot experimentation approach
46
• Scientific data review - make sure we don’t
find what is already known
• Using natural language processing, machine
learning, deep learning
• Design methodology for understanding
patient behavioral phenotypes
• Run small scale real-world pilots
• Experience building a datamart that unites
google, sanofi and publicly available data
• Emphasis on country level implementation
1
2
3

28/06/2018 47
EVIDATION: THE METHODOLOGY
We conducted a retrospective study of
influenza-related outcomes (IRO) among
fully insured Type 2 diabetics from a
large US payer over a 1 year period
covering the 2016-17 influenza season.
We used bivariate analyses (54,656
diabetics, mean age 54.8 yr, s.d. = 10.2)
to compare IRO’s inferred from claims
data against IRO’s for 113,016 age and
gender matched non-diabetics.
Samson S, Lee W et al. D Using Claims and Consumer Wearable Devices Data to Quantify Influenza-Related
Outcomes among Type 2 Diabetes Patients—A Large Population Study [abstract]. ADA, Orlando, June 22, 2018.

28/06/2018 48
EVIDATION: THE RESULTS

28/06/2018 49
EVIDATION: THE RESULTS (2/2)
Within 2-weeks before and 4-
weeks after a medical claim for
influenza, diabetics with influenza
had more observed hyperglycemic
events than in a comparable non-
influenza period in the same year
(p<0.001),

28/06/2018 50
GOOGLE: METHODOLOGY
We used VaxiTrends, a proprietary dataset, to identify variables influencing vaccine uptake among adults in
the U.S., China, France, Mexico, and U.K. We combined the data with National Health Interview Survey
results from the CDC, which offer insights into health behaviors of Americans with diabetes.
This information was aggregated with
data from Google FluTrend, which
signals flu incidence, & Google Trends
Application Programming Interface,
which tracks search keyword popularity
by location & date in a de-identified
fashion.
Cluster analyses indicated factors most
positively & negatively associated with
acceptance & adherence
Liska, J, Gupta A et al. D Using Claims and Consumer Wearable Devices Data to Quantify Influenza-Related Outcomes among Type 2
Diabetes Patients—A Large Population Study [abstract]. ADA, Orlando, June 22, 2018.

GOOGLE: RESULTS
51
factors impacting flu vaccination vary by country for people living with diabetes
Orderedintermsofimportance
fromHighestinfluencertoLowest
Negative Factors
Positive Factors

28/06/2018 52
GOOGLE: RESULTS
Adherence Impact Calculator
Google created a country specific
dashboard for local users to identify
behavioral drivers of flu vaccination &
the most receptive subgroups to
design tailored interventions to
increase uptake

Access to the right data remains a barrier
53
Improved vaccine
coverage estimates at
finer level
Individual, physician, pharmacy,
workplace
…not about personal data but better
understanding

WHAT do we aim at delivering and HOW?
55
… to generate end 2017 value from Medical to Business Operations
1) Augmented data value
2) Accelerated evidence generation
3) Simplicity and scale of insights
4) Actionable learnings for the business
5) Continuous insight and performance
observation
1) Vaxitrend survey data for 2015
comprising of 5 countries (France,
USA, UK, Mexico and China)
2) Combined with Google’s Trends and
Flu Trends
3) … and NHIS* datasets
3 DATA SOURCES 5 DELIVERABLES
*The National Health Interview Survey (NHIS) has monitored the health of the US nation since 1957. NHIS data on a broad range of
health topics are collected through personal household interviews.
November 8th 2017Flu & Diabetes – Google Pilot Advancement Status

China7 Quick win segment over clinical inertia
56
Insight: This group can be easily activated by a targeted campaign
• High intent to vaccinate
despite having zero adherence
• Scared of catching flu
• Takes action to protect
themselves against flu
• Seeks information about
health issues
China7
FOR ENDORSEMENTEARLY RESULTS – DRAFT VISUALISATIONS – WORK IN PROGRESS
China7 àQuick win segment over clinical inertia
8
Insight: This group can be easily activated by a targeted campaign
• High intent to vaccinate
despite having zero adherence
• Scared of catching flu
• Takes action to protect
themselves against flu
• Seeks information about
health issues
China7
November 8
th
2017Flu & Diabetes – Google Pilot Advancement Status

US3 Effort intensive segment for Higher Adherence
57
Insight: This group living with Diabetes should not be prioritized
• No intent to Vaccinate
• Issue with Accessibility
• Not in favor of Vaccination
• Don’t take flu job in spite of
reminders
• Think that they will not be
vulnerable to flu.
US3

Google Influenza Trends Offers Regional Granularity
58
In a single view adherence with respect to Geographical level.
Search trends for both positive and
negative terms are observed .

KEY FACTORS IMPACTING FLU VACCINATION ADHERENCE…
59
… vary by country for people living with Diabetes
Orderedintermsofimportance
fromHighestinfluencertoLowest
Negative Factors
Positive Factors

Social Media and Immunisation
Philip Weiss
Chairman
ZN Consulting
#ImmuTech

https://prezi.com/r2rpwzixz7uk/fakenews-tweets-and-healthcare-
brussels/
#ImmuTech

Local views and information on the current
Italian communication & digital context
Prof Pier Luigi Lopalco
Department of Translational Research and New
Technologies in Medicine and Surgery,
University of Pisa
#ImmuTech

SItI–SezioneApulo-LucanaCorsoFADemergenzeInfetticeinSanitàPubblica-2016
LOCAL VIEWS AND INFORMATION ON THE
CURRENT ITALIAN COMMUNICATION &
DIGITAL CONTEXT
Pier Luigi Lopalco
26 June 2018, Brussels

2009, flu pandemic
64
5 rules to better fight flu
Pandemic flu is
a normal flu

65
November 2014

66
Lethal
injection

Immunization coverage >64 yrs
67Data source: Ministry of Health
%
Pandemic vaccination campaign
“Fluad case”

68
Rimini’s Court: “Measles vaccine causes autism”
According to judges in Milan Court there is a link
between hexavalent vaccine and autism
March 2012
September 2014

Italy, 2014
69

Google’s thermometer
70
0
10
20
30
40
50
60
70
80
90
100
jan
10
mar
10
may
10
july
10
sept
10
nov
10
jan
11
mar
11
may
11
july
11
sept
11
nov
11
jan
12
mar
12
may
12
july
12
sept
12
nov
12
jan
13
mar
13
may
13
july
13
sept
13
nov
13
jan
14
mar
14
may
14
july
14
sept
14
nov
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jan
15
mar
15
may
15
july
15
sept
15
nov
15
RelativeSearchVolume(RSV)
vaccine measles autism vaccines autism vaccine autism MMR autism vaccine measles mumps rubella autism
Aquino, F., et al. The web and public confidence in MMR vaccination in Italy. Vaccine, 2017
Rimini’s court
Milan’s court

Vaccination coverage, Italy 2009-2015
71
85
87
89
91
93
95
97
99
2009 2010 2011 2012 2013 2014 2015
Polio MMR
%
Data source: Ministry of Health - Italy

72
May 2016: enough is enough

Digital in Italy
30M active social media users on mobile
73

April 2015
12.000
4.800
4.600
4.100
4.000
3.100
3.400
2.600
2.200

Echo chambers
Comilva
VaccinarSì
“borderline”

Vaccine & Autism
on YouTube in Italian
76
2007 2009 2010 2011 2012 2013 2014 2015 2016 2017
negative 1 4 18 5 18 28 27 46 96 147
positive 0 0 0 1 0 0 13 18 42 54
neutral 0 0 0 0 2 1 8 3 5 23
0
20
40
60
80
100
120
140
160
n°ofvideos
Donzelli G, et al. Misinformation on vaccination: A quantitative analysis of YouTube videos. Hum Vaccin Immunother. 2018

April 2015
12.000
4.800
4.600
4.100
4.000
3.100
3.400
2.600
2.200
June 2018
11.645
23.993
21.547
27.875
20.375
19.108
10.771
361.443
55.285

Vaccination coverage, Italy 2009-2017
79Data source: Ministry of Health - Italy
85
87
89
91
93
95
97
99
2009 2010 2011 2012 2013 2014 2015 2016 2017
Polio MMR
%

pierluigi.lopalco@unipi.it
www.adultievaccinati.it
@PLopalcoPublic
@PLopalco

How might technology help with adult
immunisation?
David Sinclair
Director
ILC-UK
#ImmuTech

Technology and
Adult Immunisation
David Sinclair, International Longevity
Centre – UK @ilcuk @sinclairda

The Policy Context

On the one hand

The role for new technologies
 140 years ago– first two way
phone call made
 In 2000 – ½ world had never
owned a phone
 By 2007 ½ the world had a
mobile phone
 It took 75 years for telephones
to reach 50 million users
 It took 4 years for the internet
to reach 50 million

On the other
“Ten or 15 years ago I could fly to New York in three
and a half hours on Concorde. In the Victorian age
they built a railway in five years. There is a big
divergence here”. Rory Cellan Jones

And companies are beginning to recognise the
impact of ageing

The future is bright – how can these
innovations help increase uptake of adult
vaccination?
 Using data better
 Gamification
 The Internet
 The Internet of Things
 The Sharing Economy
 Artificial Intelligence and
Robotics
 Blockchain
 Materials Science

Who has a wearble? We like competing with
our friends
The recent growth of relatively affordable wearable
monitoring technology offers huge greater potential
to support healthy ageing.

Competition with friends might encourage us
to be healthier

As might financial rewards

But humans cheat (or maintain control?)

Apps, Apps everywhere

Apps, Apps, everywhere
In August 2011, the UK
Health Minister, Andrew
Lansley called on health
professionals, patients and
app designers to “suggest
ideas for health-related
smartphone apps and
information maps”.

The sharing economy
http://www.birminghammail.co.uk/whats-on/food-drink-news/brum-
chef-opens-indian-restaurant-7190927

More of this sort of thing?

More use of our data?
 It may be possible to predict dementia based on
our spending patterns.
 Royal Free allowed DeepMind to have 1.6 million
NHS records
 Chinese Government put up online for free a
dataset with 1 million to 2 million health records.

 Every single resident was
tracked; their activity on social
networks, their purchases, their
movements, their commutes –
everything was uploaded to the
AI’s database, which then made
real-time decisions.
 Traffic congestion, road
accidents, and crime are all
down.
 It’s also wired up to everyone’s
mobile phones, informing them
of upcoming road traffic or
adverse weather conditions in
real-time.

 New digital records have the potential to automatically
generate lists that identify undervaccinated populations,
determine which vaccines are overdue, and generate
reminders for doctors and the public.
 Nanotechnology could deliver new ways of delivering
vaccines which address the fear of the needle (e.g.
oral/nasal/Nanopatch)
 A humanoid robot might distract us from the pain.
 A ‘digital necklace’ or app could helping store our
vaccination history.
 Services like PatientsLikeMe allow patients share
information about adult vaccination with their peers
and with medical practitioners.
 Real time information services similar to Google Flu
Trends can highlight the immediate risk of vaccine
preventable diseases.

It has taken us 20 years to get Electronic
Patient Records (and counting)
1997: Government said they would
“harness the enormous potential benefits of
IT to support the drive for quality and
efficiency in the NHS by: making patient
records electronically available when they’re
needed using the NHSnet and the Internet
to bring patients quicker test results, on-line
booking of appointments and up-to-date
specialist advice…developing telemedicine
to ensure specialist skills are available to all
parts of the country”.

How can we better engage older people
Only 60% of retired people
agreed that technology
“makes things better”
Over half thought that
technologies “fail when you
need them most” (2)

How can we better engage older people
“But how much
smaller do we want
a phone?”
Some/many do want
new technology
but: “I don’t want to
live in a smart-
home – I’d rather
be dead”
Of more than 25,000 people
questioned in a 2012 survey of
attitudes in the European Union,
60 per cent thought robots that
care for children, the elderly and
the disabled should be banned
outright; and 86 per cent said
they would be
uncomfortable with one caring
for their children or parents

How can we engage with the ethical issues?
Moral and ethical
debates – cant afford
to ignore them
Must help older people
choose technology
when it is right for
them (tagging/urine
tests)
Privacy

 How do we ensure that new technology isn’t just a
gimmick, or worse, a distraction from evidence based
interventions?
 How can new technologies tackle inequalities in access
and uptake as opposed to increasing them?
 How can we “win the hearts and minds” of citizens?
 How can we ensure that regulation protects consumers
but does not prevent innovation?
 Should policymakers be looking for better evidence of
effectiveness or regulation of “apps”, games, or other
solutions?
 Inclusive Design Might a European Accessibility Act help?
 How can we tackle digital exclusion among older adults?
 How can we ensure a greater innovation focus on
adults.

Putting ourselves in the shoes of someone
who isn’t vaccinated
Why don’t adults get vaccinated?
#ImmuTech

Why don’t adults get vaccinated?
1) Develop 4 Personas (10 minutes)
2) Consider why they might not be vaccinated (10 minutes)
a) Man, 80, has not had a vaccination since he was a child
b) Man, 65, not a native speaker. Ethnic minority
c) Woman, 70, lives alone
d) Woman, 55, freelance professional

The Playing Cards – your job
 Playing Higher or lower, pt. I - Ideas for using
technology
 Playing Higher or lower, pt. 2 - Barriers to
using technology
 Playing higher or lower, pt. 3 - Policy and
practical solutions to using technology

What should you write on your cards?
On one card - one idea for using technology e.g.
– A “bot” could be used to talk people through their worries about
vaccination
– Uber could deliver a nurse to your house so you could be
vaccinated
On one card – one barrier to using technology e.g.
– People are fearful of “Fake News” and don’t trust online
messaging
– People don’t want their data shared
On one card - one Policy and practical solutions to using technology e.g.
– Good data protection regulation (GDPR?)
– Legislation to ensure easier to use websites

Lunch
#ImmuTech

Plan for the afternoon
David Sinclair
Director
ILC-UK
#ImmuTech

Playing Higher or lower, part 1 – Ideas for
using technology
#ImmuTech

Playing Higher or lower, part 2 – Barriers to
using technology
#ImmuTech

Playing Higher or lower, part 3 – Policy and
practical solutions to using technology
#ImmuTech

Feedback – ‘Why don’t adults get
vaccinated?’ and ‘Higher and Lower’
#ImmuTech

Conclusion
#ImmuTech

Bogdan Wenta MEP
Group of the European People’s Party
(Christian Democrats)
Poland
#ImmuTech

Julie Girling MEP
Group of the European People’s Party
(Christian Democrats)
UK
#ImmuTech

Reactions from the day
#ImmuTech

Dr Wendy Yared
Director
Association of European Cancer Leagues
#ImmuTech

www.europeancancerleagues.org
www.cancercode.eu 4th Revision 2014 (1st developed in 1987)
Financed by the European Commission
The European Code Against Cancer focuses on actions that individual citizens can take
to help prevent cancer.
Successful cancer prevention requires these individual actions to be supported by
governmental policies and actions.
1 Do not smoke. Do not use any form of tobacco.
2 Make your home smoke free. Support smoke-free policies in your workplace.
3 Take action to be a healthy body weight.
4 Be physically active in everyday life. Limit the time you spend sitting.
5 Have a healthy diet:
• Eat plenty of whole grains, pulses, vegetables and fruits.
• Limit high-calorie foods (foods high in sugar or fat) and avoid sugary drinks.
• Avoid processed meat; limit red meat and foods high in salt.
6 If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for
cancer prevention.

www.europeancancerleagues.org
www.cancercode.eu
•www.cancercode.eu 4th Revision 2014 (1st developed in 1987)
Financed by the European Commission
7 Avoid too much sun, especially for children. Use sun protection. Do not use sunbeds.
8 In the workplace, protect yourself against cancer-causing substances by following health
and safety instructions.
9 Find out if you are exposed to radiation from naturally high radon levels in your
home. Take action to reduce high radon levels.
10 For women:
• Breastfeeding reduces the mother’s cancer risk. If you can, breastfeed your baby.
• Hormone replacement therapy (HRT) increases the risk of certain cancers. Limit use of
HRT.
11 Ensure your children take part in vaccination programmes for:
• Hepatitis B (for newborns)
• Human papillomavirus (HPV) (for girls).
12 Take part in organized cancer screening programmes for:
• Bowel cancer (men and women)
• Breast cancer (women)
• Cervical cancer (women).

Lana Crnjac
Interim CEO
European Liver Patients’ Association
#ImmuTech

Marius Tudor
Project Manager
European Public Health Alliance
#ImmuTech

Next steps
David Sinclair
Director
ILC-UK
#ImmuTech

Immunisation in a digital world - Futures Workshop

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