Within various projects I investigate the intradermal administration of smaller vaccines doses of different vaccine platforms (e.g. yellow fever, hepatitis B, COVID mRNA vaccines, rabies etc.), and with new applications (e.g. micro needles). For several vaccines we have shown that a one fifth or even one tenth vaccine dose is equal to the standard dose, and we are able to provide these vaccines at a lower cost at our Travel Clinic, for example for rabies vaccine. Evidently, our aim is primarily to enhance global vaccine availability, in which also other logistical hurdles besides vaccine availability such as the chold chain and vaccine administration infrastructures must be overcome.
My clinical work focuses mainly on diagnosing and treating patients with immune disorders (inborn or acquired) who have recurrent infections. From a prevention focus I combine this clinical work with research, where we analyse the development of vaccine responses (e.g. against pneumococcal vaccines) to understand where the possibilities lie for enhancing vaccine responses trough alteration of vaccine composition or vaccination schedule. To investigate this initial phase of the vaccine response, I set up a lymph node fine needle aspiration platform to measure the germinal centre in the lymph node. Germinal centers (GC) are specialised structures that form within secondary lymphoid organs, such as lymph nodes and spleen, during an immune response. The GC has been described as “evolution in miniature”: it is the birthplace of antigen specific immune responses, with B-cell proliferation, mutations and competition for limiting resources in the form of antigen and T cell help. Better understanding of the GC will provide targets for controlling, and thus enhancing adaptive immune responses, an indispensable tool for vaccine development.
Currently, we started a project environmental influences on our immune system, where we investigate the effect of different PFAS on vaccine responses in the Dutch population. This approach is dual, from an epidemiological perspective investigating associations of PFAS concentrations in large Dutch serosurveillance cohorts from the national institute for public health and the environment. And from a mechanistical perspective with the use of lymphoid tissue culture vaccine responses
