02 Jun The critical role of pneumonia-fighting vaccines in the context of COVID-19 and Sustainable Development Goals
A child receives routine immunizations, including pneumococcal vaccine, at a clinic in The Gambia. Photo: PATH/Lauren Newhouse
June 2020
Expansion of “pneumonia-fighting” vaccines* during the COVID-19 pandemic and beyond is critical. It will not only reduce the risk of increases in child pneumonia deaths from non-SARS-CoV-2 causes during the pandemic, but will also reduce the risk of adult co-infection with bacterial pneumonia and SARS-CoV-2, taking the pressure off already stressed health systems. Both are critical for the achievement of the Sustainable Development Goals by 2030.
But currently there are wide gaps in coverage of pneumonia-fighting vaccines. One out of every two children under five in the world is not fully protected with these vaccines. These children are dangerously exposed to pneumonia and at risk of infecting others.
Of greatest concern are the countries with very low coverage of the pneumonia-fighting vaccines and high numbers of child pneumonia deaths, including India, Nigeria, China, Chad, Philippines, Indonesia, Egypt, South Sudan, Somalia, Guinea, Tajikistan, Haiti, Central African Republic, Viet Nam, Lao PDR, Iraq, Papua New Guinea, North Korea and Iran.
As all of these countries are now dealing with “double-burdens”of pneumonia from SARS-CoV-2 and childhood pneumonia, they need to take action to increase coverage of the pneumonia-fighting vaccines and strengthen their health systems to control pneumonia for the long term.
Accordingly, this report recommends that:
- National governments must commit to fully protecting all children under five years of age with the WHO-recommended pneumonia-fighting vaccines by 2030, including with three doses of the pneumococcal conjugate vaccine (PCV), the haemophilus influenzae type B vaccine (Hib) and the diphtheria, tetanus and pertussis vaccine (DTP), and two doses of the measles vaccine (MCV).
- International donors must fully replenish Gavi, the Vaccine Alliance (Gavi) in 2020, so that Gavi-eligible countries have the support they need to fully protect all children under five years of age with the existing pneumonia-fighting vaccines.
- International donors and global health agencies should continue to support existing and new vaccine manufacturers to ensure the continued supply of affordable, quality pneumonia-fighting vaccines, especially PCV, for both Gavi-eligible and non-eligible countries, so that all children and other vulnerable populations can be protected.
- National governments should make plans to introduce emerging pneumonia-fighting vaccine as they become available, including a vaccine for SARS-CoV-2, the virus that causes COVID-19, respiratory syncytial virus (RSV) and improved influenza vaccines, prioritizing access to the most vulnerable populations (e.g., children, the elderly, healthcare workers etc), as appropriate for each vaccine and in each country setting.
- During the COVID-19 pandemic, national governments must make every effort, with support from global health agencies where necessary, to continue to vaccinate children with the pneumonia-fighting vaccines, reducing the risks of increases in child deaths from all-cause pneumonia and increases in adult and child deaths from COVID-19 due to co-infection.
- National governments and global health agencies should adopt a “life-cycle” approach to protection with the pneumonia-fighting vaccines, by ensuring that both children and the elderly are protected, especially in those countries experiencing a “double-burden” of pneumonia deaths among both populations.
- Delivery of the pneumonia-fighting vaccines should form part of national Pneumonia Control Strategies that ensure access to the range of preventive (e.g., vaccines, child nutrition, air pollution, WASH etc), diagnostic (e.g., pulse oximetry) and treatment (e.g., oxygen therapies and recommended child-friendly antibiotics where appropriate) services that are required to achieve universal health coverage and the Sustainable Development Goals (SDGs).
* 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.
Author: Leith Greenslade, Coordinator, Every Breath Counts Coalition