Data Linkages for improved infectious disease surveillance in Belgium: The EPI-LINK project

Abstract Background The COVID-19 pandemic highlighted the importance of data linkage to set up an efficient epidemiological surveillance of COVID-19. As such, direct linkages were established between laboratory test results, vaccination status, disease outcome and clinical and administrative records. This approach can be extended to other infectious diseases, including newly emerging pathogens, to improve both continuous surveillance and pandemic preparedness with the aim to steer protective measures to improve population health. The implementation of the EPI-LINK project for routine surveillance or in the event of a Public Health Emergency (PHE) is described here. Methods The EPI-LINK project integrates existing data collections through individual linkage using the unique national registry number. It involves linking infectious disease data (e.g. laboratory test results and clinical hospital data) with other health and administrative data, including vaccination registers, healthcare consumption data, mortality data, and socio-economic and demographic information. This elaborate linkage comes with a number of legal, technical and logistical challenges to address. Results EPI-LINK allows to build an infrastructure that will enable more comprehensive analyses to be carried out for improved surveillance of infectious diseases in Belgium, either in routine circumstances or in the event of a PHE. The expected outcomes include, but are not limited to: having more complete accurate data on vaccination status for cases, monitoring cause-specific mortality for specific pathogens using a proxy, more accurately estimating the number of cases via capture/recapture methods, assessing vaccine uptake, safety and effectiveness. Conclusions The EPI-LINK project will reinforce the continuous surveillance of infectious diseases. The linkage of datasets can be expanded to allow for the collection and analysis of more granular data, which can support public health decision-making during a PHE Key messages • By integrating different data sources at an individual level, the EPI-LINK project will reinforce the continuous surveillance of infectious diseases in Belgium. • EPI-LINK will build an infrastructure that can be expanded to allow for the collection and analysis of more granular data, which can support public health decision-making during a PHE.