In­fant vac­cine drive pays off for SA

The Star Early Edition - - NEWS - VUYO MK­IZE

IN 2009, South Africa be­came the first African coun­try to in­cor­po­rate the pneu­mo­coc­cal con­ju­gate vac­cine (PCV) into its rou­tine in­fant im­mu­ni­sa­tion pro­gramme.

And now, five years later, that decision has been proved to have made a sig­nif­i­cant ef­fect in re­duc­ing rates of in­va­sive pneu­mo­coc­cal dis­ease (IPD) – re­sult­ing in se­vere pneu­mo­nia or menin­gi­tis – in­clud­ing re­duc­ing cases caused by an­tibi­otic-resistant bac­te­ria.

Wits Univer­sity and the Na­tional In­sti­tute for Com­mu­ni­ca­ble Dis­eases (NICD) re­leased a study: “Ef­fects of Vac­ci­na­tion on In­va­sive Pneu­mo­coc­cal Dis­ease in South Africa”, which co­in­cided with World Pneu­mo­nia Day yes­ter­day.

The study, which has been pub­lished in the lat­est edi­tion of the New Eng­land Jour­nal of Medicine, com­pares in­va­sive pneu­mo­coc­cal dis­ease in­ci­dence after the in­tro­duc­tion of PCV (2011 and 2012) to in­ci­dence prior to its in­tro­duc­tion (2005 to 2008).

“The seven-va­lent (strain) PCV was in­tro­duced with the use of a novel three-dose sched­ule, with two pri­mary doses given to in­fants at six and 14 weeks of age, and a booster at nine months. In April 2011, a 13-va­lent PCV re­placed PCV7,” the study said.

Re­searchers used ob­ser­va­tional data to ex­am­ine trends in the rates of in­va­sive pneu­mo­coc­cal dis­ease in all age groups in the pop­u­la­tion be­fore and after the PCV, with strat­i­fi­ca­tion ac­cord­ing to HIV sta­tus.

The study showed a sig­nif­i­cant de­cline in in­va­sive pneu­mo­coc­cal dis­ease in chil­dren and in adults who had not been vac­ci­nated, which demon­strated the in­di­rect pro­tec­tion as chil­dren were the most common car­ri­ers.

Through vac­ci­na­tion in chil­dren, the dis­ease spread to un­vac­ci­nated adults plum­meted, the study said.

Among chil­dren younger than 2, the over­all in­ci­dence of in­va­sive pneu­mo­coc­cal dis­ease de­clined by about 70 per­cent after the in­tro­duc­tion of the vac­cine, and the rates of in­va­sive pneu­mo­coc­cal dis­ease caused by bac­te­ria specif­i­cally tar­geted by the vac­cine dropped nearly 90 per­cent.

“This study demon­strates sig­nif­i­cant de­clines in IPD cases caused by bac­te­ria resistant to one or more an­tibi­otics, a phe­nom­e­non of grow­ing con­cern among health pro­fes­sion­als.

“In fact, the rate of in­fec­tions resistant to two dif­fer­ent an­tibi­otics de­clined nearly twice as much as in­fec­tions that could be treated with an­tibi­otics,” the univer­sity said in a state­ment.

The in­sti­tu­tion said this greater ef­fect of vac­ci­na­tion on an­tibi­otic-resistant strains points to a valu­able added ben­e­fit of im­mu­ni­sa­tion.

Dr Anne von Got­tberg, a clin­i­cal mi­cro­bi­ol­o­gist, head of the cen­tre for res­pi­ra­tory dis­eases and menin­gi­tis at the NICD and lead au­thor of the pa­per, said yes­ter­day: “We’re re­ally happy. It’s a good story from Africa. Many coun­tries in Africa have in­tro­duced or are plan­ning to in­tro­duce the vac­cine.”

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