23 Apr The critical role of pneumonia vaccines in an era of respiratory pandemics
Children and adults living in countries that do not offer pneumonia-fighting vaccines are dangerously exposed to pneumonia and at risk of infecting others.
Pneumonia is the leading infectious killer claiming the lives of 2.5 million, including 672,000 children under five, in 2019. COVID-19 threatens to increase the total burden of respiratory infection deaths from 2.5 million to an estimated 4 million in 2020. No other infection causes this burden of death.
The “pneumonia-fighting” vaccines include the pneumococcal conjugate vaccine (PCV) and the haemophilus influenzae type B vaccine (Hib), which target the leading bacterial causes of childhood pneumonia, as well as vaccines against diphtheria, tetanus, and pertussis (DTP) and measles (MCV), as both pertussis and measles can cause pneumonia, and now COVID-19 vaccines.
The expansion of this “basket” of pneumonia- fighting vaccines has contributed to a 57% decline in childhood pneumonia deaths since 2000, from an estimated 1.6 million to 672,000. When Kenya introduced PCV in 2011, the average annual incidence of severe pneumococcal disease dropped by a dramatic 92% among children under five years.
But despite recent progress, there are still massive gaps in the coverage of pneumonia-fighting vaccines – particularly PCV:
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- More than four out of every ten children under five globally is not fully protected with the PCV. That is more than 300 million children.
- Most (84%) of the world’s zero-dose PCV children live in just 25 countries.
- 52 countries do not offer the PCV at all, including countries with more than 3,000 annual child pneumonia deaths – China, Somalia, Chad, Guinea, Egypt and South Sudan.
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Children and adults are paying with their lives
The cost of low coverage of the pneumonia-fighting vaccines is starkly measured in lives lost to pneumonia. An estimated 380,000 (57%) of child pneumonia deaths are in countries with low pneumonia vaccine coverage.
Of grave concern are the zero- and low-dose pneumonia vaccine countries with the heaviest burdens of child pneumonia deaths – notably, Nigeria and India, as well as China, Somalia, Democratic Republic of Congo, Chad, the Philippines, Indonesia, Guinea and Egypt. Alarmingly, pneumonia deaths have risen in Chad and Somalia over the past decade. In many countries slow progress in pneumonia vaccine coverage is threatening the achievement of the global target of less than three child pneumonia deaths for every 1,000 children born by 2025.
Also, of great concern are the countries experiencing high numbers of both COVID-19 deaths and child pneumonia deaths, including India, Somalia, the Philippines, Indonesia, Guinea, Egypt, Iraq, Venezuela and Iran. To date, not one of these countries has been able to vaccinate more than 10% of their population with one dose of a COVID-19 vaccine. Universal access to a COVID-19 vaccine and increasing coverage of the pneumonia-fighting vaccines is critical in these “double-burden” countries as their health systems are stretched to breaking point by the pandemic.
In its report, Every Breath Counts is calling on governments and global health agencies to adopt a “life-course” approach to pneumonia vaccination and develop policies and programs that prioritize full coverage of all of the pneumonia-fighting vaccines, including COVID-19, to children and the elderly, and to other vulnerable populations.
The Coalition is also urging governments to support the development of new vaccines, including for Respiratory syncytial virus (RSV) and influenza, the leading viral causes of pneumonia among children. This would strengthen the basket of pneumonia-fighting vaccines and make a major contribution to reducing all-cause respiratory infection deaths.
In an era where respiratory pandemics are increasingly likely, pneumonia-fighting vaccines have become even more critical. Protecting children and adults everywhere with pneumonia vaccines, especially the most vulnerable, has become a critical global health goal in the 21st century.
In support of World Immunization Week
April 2021