Preventing pneumococcal disease through vaccination

Three medical specialists underscored during a lay forum held at the Marco Polo Hotel how important it is to continue promoting the health and wellbeing advocacy to fight pneumococcal disease.

Pulmonologist Aileen Wang of the Manila Doctors Hospital, infectious disease specialist Rontgene Solante of San Lazaro Hospital-Manila and Prof. Charles Feldman of Charlotte Maxeke Johannesburg Academic Hospital-South Africa took turns in discussing the numerous efforts that have been undertaken to control the disease.

4th leading cause of death

Pneumonia is a lung infection wherein the air sacs become filled with fluid or pus caused by bacteria, virus, fungi or parasites. It causes about 1.6 million annual deaths worldwide.

In the country, it is the fourth leading cause of death affecting 35,756 individuals between 2004 and 2008. A year after, the number of deaths increased to 42,542. By 2010 Filipinos suffering from pneumonia and respiratory tract infection totaled 586,186.

Transmission

The bacteria Streptococcus pneumoniae cause pneumococcal pneumonia, which starts at the nose and throat (nasopharyngeal) and spreads to the lungs. The disease is transmitted to an individual who inhales tiny airborne droplets from an infected person.

The bacteria can live in the nose without causing disease. To help prevent transmission of pneumococcal disease, there’s a need to reduce the nasopharyngeal carriage of the bacteria.

Invasive pneumococcal disease (IPD) happens when the bacteria infect the blood, a condition called bacteremia. It can infect the spinal cord and result in a disease called meningitis. When the ears are affected, it is called acute otitis media.

Those at higher risk

IPD is a major cause of disease and death globally. It affects particularly the very young (less than 5 years old) and the elderly (over 55 years old). Adults with heart diseases are three to 10 times more likely to develop IPD while those with longstanding lung diseases are five to 17 times more prone to develop the disease.

Among the risk factors for pneumococcal disease are smoking, exposure to indoor air pollution and living in crowded places.

To control pneumococcal disease, the risk factors associated with the socioeconomic ones should be lowered and the underlying conditions should be managed.

The economic impact of the disease are hospital and rehospital cost, absenteeism and productivity.

Pneumonia is treated by antibiotics prescribed by doctors. Antibiotic resistance, however, is a global concern.

According to studies, pneumococcal disease can be prevented through vaccination. In fact, it is highly prioritized by the World Health Organization for universal vaccination.

Adult vaccination rates for pneumococcal disease, however, are below the desired targets, even for countries with established immunization programs.

The vaccination rates for the elderly more than 60 years of age in Belgium, the United Kingdom and Ireland are 13, 69 and 41 percent, respectively. The vaccination rate for the United States is 59.9 percent for those more than 65 years old. There is no data currently available in the country.

PCVs

The pneumococcal conjugate vaccine was initially used for the pediatric age group. The 13 valent conjugated pneumoccocal vaccine was approved in 2010 by the country’s PDA for children 6 months to 5 years old.

Two years later, its use was extended to include children until 17 years old. Indication was expanded to adults 18 years old and above during the latter half of 2013.

The use of the same vaccine in the elderly—65 years old and above—was further supported by the recently published Capita study which showed the efficacy of the vaccine in preventing the first episode of vaccine-type community-acquired pneumonia and invasive pneumococcal disease.

Results in another study showed the effectiveness of the same vaccine against CAP among adults aged 65 and above was similar to that of the influenza vaccine.

Important mission

When a person is vaccinated, he/she gets direct protection against pneumococcal disease. Indirect protection is likewise given to unvaccinated individuals because the spread of disease is limited by the proportion of the vaccinated persons in the population.

Raising awareness against pneumococcal disease is important to continue. Advocating prevention through vaccination is likewise necessary. Everyone is urged to ensure that the elderly is also protected from the disease.

Over 90 different pneumococcal types (serotypes) can cause the disease in humans.