I hope you all reconnected with family and close ones safely and recharged your batteries. The start of each year also comes with new year’s resolutions. This year, like none other before, is filled with hope and high expectations that it will be the year in which we’ll re-gain our lives back from a bug one ten millionth our size. I wonder what genius coined the expression “little things lead to little problems and big things lead to big problems”. I’ll come back to this a little later.

Vaccines have underlined how critical they are in our armoury against infectious disease outbreaks and public trust in vaccines is key to irradicating COVID-19. Our COVID-19 toolbox is never richer than before, and I remain impatiently optimistic that through our collective efforts we will beat that faceless microscopic spiky protein. We have seen the most negative effects of the pandemic on both nationaland supranational levels: the increase in poverty and health inequities based on socioeconomic status, gender, geography, or ethnic identity. This has deepened existing inequalities and exposed the shortcomings of public health systems, particularly in low-and middle-income countries, but also in high-income countries which were considered best prepared to face pandemics. Socioeconomic and epidemiological studies have demonstrated how just one little bug has interrupted basic health services, such as routine pediatric immunization and the continued health care provision for the prevention and management of chronic diseases like TB, HIV, Hepatitis B and C.

A side effect of the competition between the numerous vaccine companies involved in this battle has been that it led to increased disease awareness campaigns that explain the benefits of vaccines directly where possible to the patients, parents and carers in the community. Hats off to those young and agile vaccine companies primarily for undertaking such broader disease vaccine awareness programs prior to seeking Emergency Use Approval for their SARS-CoV-2 vaccines. Those achievements are paving the way for combination vaccines for respiratory diseases in the young as well as in older adults, with many of the major vaccine companies joining the race for the next exciting/impactful mRNA combo vaccine.

Our project VITAL has never been more Vital, with the highest death toll from COVID-19 occurring in people with preexisting medical conditions and older adults. Within VITAL we are at the cusp of gaining better understanding of immune markers, and the mechanisms underlying the frailty and immunosenescence in older adults, and, this should enable us to figure out what intrinsic factors of our immune system impact our biological age. I’m very excited and encouraged by the quality data that isstarting to pour out from these work packages. The VITAL epidemiology and health economic team willthis year generate new data and data analysis schemes of the ageing adult by identifying locations andseasonal patterns of disease. With simple and easily accessible model tools for different decisionmakers (including healthcare payers/providers, or financing bodies like Ministries of Finance orinsurance companies), our economic value assessment will demonstrate the much-needed stronger approach of focusing on prevention in reaching improved healthy ageing. Ultimately this will reduce costs and improve quality health gain, which will prove to be Vital given the mounting pressure in a rapidly growing ageing population that is heterogenous in both disease burden and mortality. We have the ambition to develop educational content to communicate on vaccination strategies – which is paramount to tackling the misinformation underpinning vaccine hesitancy, exposing the uphill challenge to fight off little nasties including the Omicron variant.

Finally, the pandemic that has divided history into before COVID-19 and the pandemic era has taught us “little things lead to big problems” when unprepared – so let’s get better prepared for the next one andmake 2022 count. Stay safe, take care of you and yours.

Jim Janimak, GSK
EFPIA VITAL Project Leader