Vaccination is also good for adults

Protesters from Doctors without Borders rally in front of Pfizer’s headquarters in New York on April 27, 2016. They delivered a petition demanding a lower price for their lifesaving pneumonia vaccine. Vaccines work and prevention is better than cure. PHOTO | DON EMMERT | AFP

What you need to know:

  • By the end of 2015, pneumococcal vaccine was available in 129 countries, with global coverage at 37 per cent.
  • The World Health Organization recognises immunisation as one of the greatest ways to deal with infections.

Pneumonia remains a leading cause of death, especially in children under five years.

Unicef estimates that each day, 2,500 children across the world die from the disease.

The majority of these are below the age of two years. In Kenya, data from the Ministry of Health shows 30,000 lives lost every year from pneumonia, a majority of whom are children under five.

IMMUNISATION

The death toll is higher than that of malaria, HIV and tuberculosis. The irony is that pneumonia is preventable through immunisation.

In February 2011, Kenya became the first African country to roll out the pneumococcal vaccine (PCV10) as part of the routine immunisation for children under 12 months to prevent pneumonia, meningitis and ear infections.

By the end of 2015, pneumococcal vaccine was available in 129 countries, with global coverage at 37 per cent.

RISK FACTOR

This is very low, considering the number of deaths from pneumococcal disease.

But, even as we place emphasis on child immunisation, adult vaccination is also equally important.

The pneumococcal vaccine is not only critical for children, but also for adults above 65, with chronic conditions such as diabetes, asthma and cardiovascular diseases.

Ageing is a widely recognised risk factor for pneumococcal disease, as the quality of the immune response may decline, resulting in increased susceptibility to infections.

EFFECTIVE INTERVENTION

The World Health Organization recognises immunisation as one of the greatest ways to deal with infections.

It is also one of the world’s most cost-effective health interventions.

The way immunisation works is that a harmless version of a germ is introduced to the body and the immune system responds by producing antibodies to attack the germ.

From then on, the immune system can quickly recognise and neutralise disease-causing agents.

Unfortunately, more than 30 million children are not immunised, either because vaccines are unavailable, health services are poorly provided or inaccessible, or families are not informed about when and why to take their children for immunisation.

CHALLENGES

The WHO says one in five children below the age of five who die each year, die from a vaccine preventable disease.

The current global immunisation coverage prevents two to three million deaths.

We could avoid an additional 1.5 million deaths, if the coverage was to increase.

In Kenya, the coverage has stagnated at about 80 per cent for various reasons.

Firstly, immunisation is voluntary. This has led the country to play catch-up through mass campaigns, especially with life-threatening diseases such as polio.

ANTIBIOTIC RESISTANCE

This is however very expensive and unsustainable.

Another factor slowing down immunisation is lack of awareness on the importance of prevention through vaccination.

We are seeing a rapid increase in resistance to antibiotics.

If this trend continues, we will see more deaths and complications.

Pneumococcal vaccination can reduce antibiotic resistance.

PREVENTION

Chronic kidney disease and dialysis, chronic liver disease and HIV/Aids are associated with increased risk of pneumococcal disease.

A combination of these diseases renders one even more susceptible to pneumonia.

Once admitted to hospital, sadly, a certain percentage of the patients die.

This is a constant the world over for over 40 years now. It is, therefore, best to prevent pneumonia through vaccination.

LONG-TERM COMPLICATIONS

Even in those who survive, lifelong complications such as bronchiectasis, which is irreversible airway damage and right-sided heart failure also known as cor pulmonale, may occur.

Prevention with the pneumococcal vaccine also protects against pneumococcal meningitis that has a very high mortality rate and severe complications in survivors.

The cost benefit of vaccination is such that a country such as ours would want to maximise on the proven benefits of immunisation 

Many think that as we grow older, we do not require immunisation.

HERPES ZOSTER

The opposite is true. Influenza vaccination is important at all ages, especially in under-fives, the elderly and in those with comorbid conditions such as diabetes mellitus, chronic kidney disease, chronic liver disease such as cirrhosis and hepatitis, chronic lung diseases such as chronic obstructive pulmonary disease, asthma and HIV/Aids. 

Many of the elderly suffer the pain and scarring from Herpes Zoster or Shingles, oblivious of the availability of immunisation.

All should get immunised to protect ourselves against deadly diseases.

Vaccines work and prevention is better than cure.

Dr Wanjugu is a consultant chest physician/pulmonologist. [email protected]