Analysis of the long term efficiency of vaccinations against infectious diseases in the border regions of Croatia and Hungary

Infrastructural and personal background of this project has long-term history in cross-border co-operation between applicants (CABCOS2, heathimpulse, healthmanagement). Our major aim in this joint project between the University of Pécs, Department of Immunology and Biotechnology, and the Department of Public Health Service Baranja County, Osijek – is to earn a clear and evidence based status report of immunity protection of cross-border populations in both countries against vaccine prevented communicable diseases (vpcds). A simple, fast, high throughput and cost effective laboratory method for analysing the individual immunity status against measles, mumps and rubella (MMR) has been developed and published (in high rank international scientific Journal) by the Hungarian partner. The classical vpcds have been eradicated in both countries according to the well-organized public health, but unfortunately, once eradicated highly infectious diseases, including measles have re-appeared worldwide including Europe recently. According to WHO/UN report measles cases multiply with 300% globally in 2019. Measles is one of the most contagious diseases with high risk for non-immunized or immune compromised population. In both Hungary and Croatia no domestic cases were reported during the last decades, but the number of imported measles cases is increased continuously during the last years. To save this protected status of Hungarian and Croatian population a strong and innovative co-operation is essential, because the risk is emerging with the uncontrolled increase of imported cases and with the anti-vaccine movements which are able to destroy the so-called „flock immunity” (protection of unvaccinated or none responder individuals by the vaccinated majority of the population). We have no comprehensive data about the actual immunity status against measles and other infectious diseases in population in either countries, however, the migration boom is challenging because both countries are among the most heavily affected EU regions by current migration trends. The challenge is most stressful in the common border region of Croatia and Hungary because of the intensified traffic through the border. The problems of imported vpcds are already validated according to recently published articles, and in some EU countries fatalities have occurred. To prevent residents, it is of a principal importance in both border regions to identify groups-at-risk and to define the protocol for re-vaccination. To implement this task our laboratory method for assessing the protection status against MMR– after standardization and ISO accreditation – is applicable. This project is ideal to expand the geographic coverage of survey over the borders and to develop a statistical algorithm to gain accurate knowledge of the immunologically protected status of population groups of different ages in the border region (and beyond, if possible). The direct target group is approximately 3000 – 3500 serum samples of carefully designed cohorts according to the previously planned algorithm. Through the direct target group, the project proposes to have a clear and comprehensive knowledge of representative status of vaccination of the cross-border population broken down to age, vaccines and types of vpcds. The results will be able to help the work of different specialist in both countries, e. g. The decision makers in public health services, health industry specialists interested in development of new vaccines, migration health specialists, family doctors and occupational health services, border guards and military persons, social workers, and volunteers participating in migrant crisis. The project – by the evidence based results of the cross-border survey – will able to call the attention to the importance of vaccination in wide range of society by the planned outreach activities.

Envisaged even before the COVID-19 pandemic, the project recognized the importance of vaccination in the cross-border area and set out to research the level of immunity protection in the border area population relating to infectious diseases. They developed a joint, simple and cost effective methodology to analyse the individual imnunity status against such infectious diseases as measles, mumps and rubeola in the population. The project resulted in several joint scientific publications, as well as recommendations on the vaccination policies for the future, especially in light of the challenges that the public health institutions are faced with. These include the growing scepticism in the population, resulting in the possible re-appearence of diseases that have been eradicted in the past in both countries thanks to well-organised public health.