Johannesburg - As the World Health Organisation (WHO) raises the red flag about an increase in Covid-19 cases worldwide, health experts are again stressing the importance of vaccines.
The WHO announced earlier this week that globally, there are more than 561 million confirmed cases of Covid-19 and more than 6 million deaths were reported as of July 19. Health experts say in South Africa, pneumonia remains the single most infectious cause of mortality in children worldwide and accounts for up to 14% of deaths in children under the age of 5.
While the numbers seem to paint a bleak picture, positive strides are being made to eradicate the disease thanks to vaccines. They say vaccines were still one of the most cost-effective and critical medical interventions to reduce the burden of disease and mortality.
Pneumococcal conjugate vaccines (PCVs) have averted as many as 175 million cases and 624 000 deaths associated with pneumococcal disease. These are the jabs babies get as part of the government's Expanded Programme on Immunisation (EPI) at 6 weeks, 14 weeks, and 9 months of age. With the recent scare of a measles outbreak in South Africa, the importance of childhood vaccination has once again been brought to the fore.
Professor Prakash Mohan Jeena, paediatric pulmonologist and head of the paediatric intensive care and pulmonology department at the University of KwaZulu-Natal, said vaccines remain one of the most cost-effective and critical medical interventions to successfully eradicate vaccine-preventable diseases (VPDs) and have proven effective in eradicating smallpox caused by the variola virus and rinderpest from the rinderpest virus, now eliminated thanks to vaccine intervention initiatives.
“Similar benefits are now being realised with the implementation of PCVs, with PCV7 being introduced in 2009 and the more advanced PCV13 emerging in 2011. PCVs have had a resounding impact.
“While statistics from the WHO confirm that medical interventions such as vaccinations are needed to tackle the plight of preventable diseases such as pneumonia, more needs to be done, particularly when considering that more than 740 000 children worldwide, died from pneumonia in 2019.
“The South African Department of Health’s EPI recommends that children receive three doses of the PCV13 vaccine to protect against potentially serious and even deadly infections caused by pneumococcal disease. This includes Streptococcus pneumoniae – a leading cause of bacterial pneumonia and Invasive Pneumococcal Disease such as pneumococcal meningitis. While PCV7 had little effect on lowering meningitis incidence, global studies have indicated that PCV13 has proven effective in reducing the impact of this disease by as much as 48%,” Jeena said.
When considering the burden of pneumococcal disease in children between 0 and 59 months, the number of infected children with pneumococcal disease drastically declined from 107 600 cases a year between 2005 and 2008, to an estimated 41 800 between 2012 and 2013.
Jeena added that while several interventions such as HIV care and prevention initiatives were in place during this time, this reduction can be largely attributed to the introduction of effective PCV medications, and that more needs to be done to increase childhood immunisation in South Africa.
“Vaccines save lives and the re-purposing of Clairwood Hospital in Durban is a good example of this. Once a health-care facility that dealt primarily with infectious diseases, the hospital has had to adapt its practices in recent years as infectious disease wards remained empty. South Africa’s immunisation coverage rate is lower than the 90% coverage rate set forth by the Global Vaccine Action Plan, with the country recording 83.9% in 2020, according to the (latest) EPI National Coverage Survey Report.
“While these figures are up from the 81.9% recorded in the 2018/2019 period, more needs to be done to increase South Africa’s childhood immunisation rate to prevent future disease outbreaks.”
Jeena’s sentiments are shared by the deputy vice-chancellor for Research and Innovation at North-West University and member of the Ministerial Advisory Committee on Vaccines, Professor Jeffrey Mphahlele, who said the deployment of vaccines has made significant progress in averting deaths from VPDs.
“Vaccines are estimated to prevent between 3.5 and 5 million deaths annually according to the WHO. For children under 5, pneumonia, an acute respiratory infection most commonly caused by viruses or bacteria, is the leading cause of deaths, claiming almost 15% of all deaths in this age group. The majority of these deaths occur in Africa and Asia. The Covid-19 pandemic has exacerbated the situation by disrupting health services between 2010 and 2021. As a result, it is estimated that 25 million children missing out on vaccination services in 2021,”he said.
Mphahlele concluded that vaccines remain the most cost-effective interventions preventing morbidity and mortality associated with VPDs.