Vaccination is currently underutilised in adults, despite the potential for this public health intervention to improve patient outcomes, and reduce healthcare usage and expense. Pre-licensure randomised controlled trials demonstrate vaccine safety and efficacy, but fail to evaluate the impact of these interventions in real-world settings, providing limited insight into outcomes for healthcare systems. Current post-implementation surveillance and safety studies lack detailed clinical outcomes and are limited by methodological constraints. There is therefore an urgent need to undertake well-conducted post-licensure pre-rollout (i.e. vaccine incorporation into national programmes) interventional implementation studies to provide such evidence.

This fellowship will aim to develop the methodology used within this field and undertake research that provides critical evidence for national and international public health decision making. Initially, I aim to undertake this research through an exemplar study of PCV20 (20-valent pneumococcal conjugate vaccine), which may extend into a post-implementation effectiveness study if PCV20 is implemented nationally. This would then provide a pre-existing platform to study RSV or novel influenza vaccine effectiveness.