21 Apr The critical role of pneumonia-fighting 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 6 million in 2021. 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.
Despite recent progress, there are still massive gaps in the coverage of pneumonia-fighting vaccines – particularly PCV:
- More than one out of every two children under five globally is not fully protected with the PCV. That is 345 million children.
- Most (80%) of the world’s 345 million children who do not receive PCV live in 25 countries.
- 17 of these countries do not offer the PCV, including countries with high child pneumonia deaths – China, Egypt, Viet Nam, Iran, Thailand, Chad, Somalia, Malaysia, Venezuela, Ukraine, Guinea, Syria, North Korea, South Sudan, Sri Lanka, Tajikistan and Jordan; the remaining eight have coverage rates below 60%
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 370,000 (55%) of child pneumonia deaths are in countries with low PCV vaccine coverage (below 60%).
Of grave concern are the no- and low-coverage vaccine countries with the heaviest burdens of child pneumonia deaths – notably, Nigeria and India – as well as China, Somalia, Democratic Republic of Congo and Chad. Alarmingly, child pneumonia deaths are rising in Chad and Somalia.
Most of the countries with the lowest coverage of the pneumonia-fighting vaccines are currently off-track to achieve the global pneumonia target of less than three child pneumonia deaths for every 1,000 children born by 2025.
The ‘double-burden’ countries
In 2021, 61 no- and low-coverage PCV countries, already dealing with 370,000 child pneumonia deaths, reported 356,000 COVID-19 deaths to WHO.
Of particular concern are the high numbers of both COVID-19 deaths and child pneumonia deaths in India, Indonesia, and Egypt. These, and other countries, are now dealing with “double-burdens” of pneumonia from COVID-19 and other causes, most of which are vaccine- preventable. But just 18 of the 61 countries have been able to vaccinate more than 60% of their populations with the initial doses of a COVID-19 vaccine (not including boosters).
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.
A “life-course” approach
In its report, the Every Breath Counts Coalition is calling on national governments and global health agencies to adopt a “life-course” approach to pneumonia vaccination and develop policies and programmes that prioritize full coverage 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, prioritizing access to the most vulnerable populations (e.g., children, the elderly, healthcare workers, etc.). 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 more respiratory pandemics are likely, pneumonia-fighting vaccines have become even more critical. Protecting everyone, everywhere with pneumonia vaccines, and especially the most vulnerable children and older adults in our communities, has become a critical global health goal in the 21st century.
This report is in support of World Immunization Week.
April 2022