New pneumococcal vaccine could massively reduce paediatric mortality

An estimated 700,000 deaths could be averted by 2015 with the widespread use of a new vaccine against pneumonia and other pneumococcal diseases. Pneumonia is the world’s biggest single killer of children.

Streptococcus pneumoniae, or pneumo-coccus, is a bacterium which causes serious often life-threatening illnesses in young children – among them meningitis, septicemia and pneumonia. Pnemococcus leads to an estimated 14.5 million cases of serious illness worldwide each year. It is a major public health problem. In developed countries this disease burden is carried mainly by the elderly population; in developing countries mostly by the youngest children.

Streptococcus pneumoniae is the most common cause of bacterial pneumonia in children, which kills more than 1.6 million children every year, accounting for 18% of all deaths of children under five years old worldwide.

In addition, the recent development of widespread microbial resistance to essential antibiotics underlines the urgency of tackling this disease.

Pneumonia can be prevented with simple interventions and treated with lowcost, low-tech medication and care.

Importantly, pneumonia can be prevented by immunisation.

Pneumococcal Conjugate Vaccine

PCV13 (Pneumococcal Conjugate Vaccine) has been developed to replace PCV7 for prevention of pneumococcal disease in children. Although PCV7, which has been around since 2000, has reduced significantly the 7 strains of S. pneumonia, which it acts against, other strains of S. pneumoniae that are not in PCV7 have become more common. PCV13 includes 6 additional serotypes, protecting against more disease than PCV7. In particular, PCV13 vaccine protects against serotype 19A, which has become the most common pneumococcal serotype and is often resistant to antibiotics.

Speaking at a press conference in Dubai during the Pfizer-sponsored 2nd Africa Middle East Pneumococcal Summit, Dr Nawal Al Kaabi, consultant in Paediatric Infectious Disease at Sheikh Khalifa Medical City in Abu Dhabi, explained that regional studies have shown that different S.pneumoniae serotypes predominate in different geographies and reiterated the call for public health immunisation programmes in the region to include PCV13 in their paediatric immunisation campaigns.

“The UAE has recently included it as part of its national immunisation programme, but it is not obligatory” she noted. Speaking to the media, Catherine Weil- Oliver, MD, Professor of Paediatrics, Paris VII University, Paris, France said: “It is unlikely we will succeed in eradicating the disease. So we need to control it.”

And this, she said, can be done through widespread vaccination programmes, strong public health surveillance and less use of antibiotics.

WHO has stated that Pneumococcal Conjugate Vaccines should be a priority for inclusion in national childhood immunization plans.

And the evidence is there that these vaccination programmes work. Studies in the United States have shown a significant reduction in the number of pneumonia cases following the introduction of PCV in children under 5.

- doi: 10.1086/648593).

Global Action Plan for Prevention and Control of Pneumonia

GAVI Alliance plans to rollout new vaccine to 40 countries by 2015

The GAVI Alliance plans to rollout the new vaccine – tailored for strains of pneumococcal disease prevalent in developing countries – to 19 countries within one year and to more than 40 countries by 2015. A few, including Nicaragua, Sierra Leone and Yemen, have already successfully introduced the vaccine into their routine immunisation programmes.

According to IRIN News, a “report card” issued in 2010 by the US-based International Vaccine Access Centre at Johns Hopkins University found that efforts to treat and prevent pneumonia were falling short in the 15 countries responsible for three-quarters of the world’s annual deaths from the disease. A significant factor was lack of access to new and effective vaccines.

At US$3.50 per dose, the vaccine being issued in developing countries is about 90% cheaper than in the developed world. GAVI and its partner countries will co-finance the rollout, with governments in the poorest income bracket chipping in $0.15 per dose.

A 2007 study published in The Lancet projected that accelerated uptake of pneumococcal vaccine in the world’s poorest countries would be highly cost-effective and substantially reduce childhood mortality.

Helen Evans, GAVI Alliance interim CEO, said while participating countries had shown strong commitment to ensuring quick and universal rollout of the vaccine, many of these countries would need to step up their health system capacity to achieve this.

“The further we get from big cities, the more challenging the rollout is; the vaccine requires refrigeration and we have seen issues with the cold chain, for example, in areas where electricity is a problem,” she told IRIN. “Access to families in remote areas can also be difficult.”

GAVI’s ambitious plans to roll out this and other vaccines for major killer diseases is threatened by a funding gap of US$3.7 billion over the next five years.

“If the money comes slower than anticipated, then the rollout will be slower than anticipated,” said Evans. “We are hopeful, however, that donors have a good understanding of what a good investment vaccination is.” 

 Date of upload: 10th Jul 2011


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