May 19th, 2012
WHO Recommends Developing Countries Introduce New Pneumonia Vaccine
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New guidance issued today by the World Wellness Organization (WHO) calls for the introduction of pneumococcal conjugate vaccines into immunization programmes in developing countries, beginning together with the currently licensed 7-valent vaccine (PCV7).
Pneumococcal illness will be the leading vaccine preventable cause of child deaths worldwide. WHO estimates that about 1.6 million folks, such as up to 1 million kids under 5 years old, die every year of pneumococcal pneumonia, meningitis, and sepsis.(1) In populations with high child mortality rates, pneumonia could be the leading infectious cause of mortality and accounts for about 20-25% of all child deaths.(2)
Recognizing the heavy burden of pneumococcal illness in young young children and the safety and efficacy with the PCV7 in this age group, WHO considers its inclusion in national immunization programmes as a priority, particularly in countries with under five mortality greater than 50 per 1000 live births, or higher than 50,000 child deaths annually.
“Pneumococcal illness kills as much as a million kids a year, most of them in developing countries,” said Dr Adenike Grange, President of the International Pediatric Association. “This decision is an important step in the introduction of a safe and powerful pneumococcal vaccine for creating countries.”
Dr Orin Levine, Executive Director of PneumoADIP – a non-governmental organization that aims to shorten the time between use of a vaccine in industrialized nations and their introduction inside the developing globe – commented: “GAVI’s PneumoADIP(3) applauds WHO for providing important leadership and guidance for the use of pneumococcal vaccine to prevent pneumonia in creating countries. Together with GAVI’s financing and the Advance Market Commitment, the WHO position statement is helping bring pneumococcal vaccines towards the kids who need them most, faster than ever prior to.”
Typically new vaccines take fifteen years or much more to reach developing countries. With this recommendation there is now the prospect of pneumococcal conjugate vaccine achieving regular use in Africa only eight years soon after it was introduced within the USA.
HIV infection significantly increases the risk of pneumococcal illness in youngsters and adults. Because pneumococcal conjugate vaccines have been shown to be safe and efficacious in HIV infected young children, WHO recommends that countries with high prevalence of HIV prioritize the introduction of PCV7. Furthermore, populations with high prevalence of other underlying conditions that enhance the risk of pneumococcal illness, e.g. sickle cell disease, should also be targeted for vaccination.
“Children with HIV are as much as 40 times far more likely to get pneumococcal disease than HIV-negative youngsters along with the vaccine has been shown to assist prevent the disease in these vulnerable children” stated Dr Thomas Cherian, Coordinator of the Expanded Programme on Immunization Plus, WHO Department of Immunization, Vaccines and Biologicals.
The serotypes included within the PCV7 vaccine cover 65-80% with the serotypes associated with invasive pneumococcal illness amongst young youngsters in Western industrialized countries. Despite the absence of some serotypes that are critical causes of pneumococcal illness in developing countries, PCV7 can prevent substantial mortality and morbidity in these countries. The safety and efficacy of PCV7, as with other formulations of pneumococcal conjugate vaccines, have been properly established in numerous settings each in: industrialized and creating countries; in urban and rural settings; and among infants with HIV infection.
“As a result of this recommendation, we expect pneumococcal vaccines to begin saving lives in GAVI countries in 2008. GAVI countries now have WHO’s recommendation along with the ability to obtain the vaccine via GAVI for $0.10 to $0.30 per dose”, stated Dr Orin Levine. “Recognizing that vaccines with 10-13 serotypes will become widely offered by 2010, WHO advises countries to start saving lives with all the available vaccine and then decide whether to switch to one of the other vaccines when they arrive,” stated Dr Orin Levine.
The WHO recommendation along with WHO pre-qualification of PCV 7 will set the stage for the introduction of this vaccine with GAVI support within the world’s poorest countries in 2008. Pre-qualification is a WHO procedure to guarantee the safety and efficacy of all vaccines purchased by the UN agencies.
Introduction of any new vaccine requires careful attention to surveillance and pneumococcal vaccine is no exception. WHO encourages countries to conduct appropriate surveillance for pneumococcal invasive illness to establish the baseline and monitor the impact of vaccination, such as the occurrence and magnitude of replacement illness. This is especially essential in creating countries which are amongst the first to introduce vaccine into their national programs and in countries with high prevalence of HIV infections, or other conditions recognized to increase the risk of pneumococcal illness.
Pneumococcal illness affects persons of all ages. The risk of serious illness remains high throughout the very first 24 months of life. When PCV7 is 1st introduced into routine childhood immunization programmes, maximum individual and community-level protection might be achieved by also providing a single catch-up dose with the vaccine to previously unvaccinated young children aged 12-24 months, and to high risk young children aged 2-5 years.
Other pneumococcal vaccines in development, which contain further serotypes targeting strains with the disease that commonly cause death and disability within the creating world, are in advanced stages of testing and are expected to become available to developing countries between 2009 and 2011. Introducing the 7-valent vaccine now means that lives can start off to be saved straight away. This vaccine, manufactured by Wyeth, is successful, well-tolerated and may be delivered through existing immunisation systems. Surveillance data from the USA(four) indicate that the herd immunity(x) impact from routine childhood pneumococcal vaccination prevents twice as a lot of instances as the direct effects of vaccination alone, protecting vulnerable adults as nicely as children.
(x) Herd immunity is the resistance of a population to spread of an infectious organism due to the immunity of a high proportion with the population – the US study suggests that the herd immunity impact of pneumococcal vaccination could possibly be especially strong.
References
1. World Wellness Organization. Pneumococcal vaccines. Wkly Epidemiol Record 2003;14:110-19
2. Williams BG, Gouws E, Boschi-Pinto C et al. Estimates of worldwide distribution of child deaths from acute respiratory infections. Lancet Infect Dis 2002;2:25-32
3. Pneumococcal Vaccines Accelerated Development and Introduction Plan – funded via a $30 million grant from the GAVI Alliance
4. Centers for Illness Control and Prevention. Direct and Indirect Effects of Routine Vaccination of Youngsters with 7-Valent Pneumococcal Conjugate Vaccine on Incidence of Invasive Pneumococcal Disease – Unites States, 1998-2003. MMWR 2005;54:893-897.
Pneumococcal illness is an infection brought on by Streptococcus pneumoniae. When these bacteria invade the lungs, they trigger the most widespread kind of bacterial pneumonia. The bacteria can also invade the bloodstream (bacteremia) and/or the tissues and fluids surrounding the brain and spinal cord (meningitis).
According to WHO, pneumococcal pneumonia and meningitis are responsible for 800,000 to one million child deaths every year and far more than 90 percent of pneumococcal pneumonia deaths in youngsters occur in creating countries.
The Globe Well being Organization (WHO) could be the United Nations specialized agency for wellness. It was established on 7 April 1948. WHO’s objective, as set out in its Constitution, could be the attainment by all peoples of the highest feasible level of wellness. Well being is defined in WHO’s Constitution as a state of total physical, mental and social well-being and not merely the absence of illness or infirmity.
The goal of the Pneumococcal Vaccines Accelerated Development and Introduction Plan (PneumoADIP) is to shorten the time between the use of a new vaccine in industrialized countries and its introduction in developing countries by reducing demand uncertainty and achieving an affordable, sustainable supply of vaccines. This novel approach is funded by the GAVI Alliance. PneumoADIP is located at the Johns Hopkins Bloomberg School of Public Health. The mission of PneumoADIP is to boost child survival and well being by accelerating the evaluation of and access to new life saving pneumococcal vaccines for the world’s kids.
pneumoADIP
http://www.preventpneumo.org/