The “Kill or Cure? Pneumococcal Vaccine” documentary is scheduled to be aired February 4th; check your local listings. In December 2005, PneumoADIP was proud to participate in the production of a Special BBC World documentary on pneumococcal vaccines. This follow-up film took an in-depth look at the success of routine pneumococcal immunization in North America (Alaska), highlighted the severe burden of disease in India and Nepal and efforts underway to introduce pneumococcal vaccines where they are needed most. PneumoADIP would like to thank colleagues and families in Alaska, Nepal and India for making this documentary possible.

The Washington Post – December 19, 2005. On the front page article, Washington Post staff writer Justin Gillis reported on the current issues around pneumococcal and rotaviral vaccine supply in developing countries. While describing the complex challenges of vaccine introduction in developing countries, Gillis reported on the urgency for innovative action to accelerate vaccine introduction in developing countries; “If the rotavirus and pneumonia vaccines take three more years to reach poor countries, 3.7 million children will have died of the diseases by then. That is 3,397 children for every day’s delay.” The role of PneumoADIP and its approach of engaging both public and private sectors to address the pneumococcal vaccine needs of developing nations were lauded.

SAGE Report on PCV: Geneva, November 9-11, 2005 - The Strategic Advisory Group of Experts (SAGE), established in 1999 by the Director-General of WHO to provide guidance on the work of the Department of Immunization, Vaccines and Biologicals (IVB), was briefed on the current status of pneumococcal conjugate vaccines; the incidence of invasive and non-invasive disease burdens; and role of PneumoADIP. SAGE expressed confidence in the available evidence of the safety and efficacy of pneumococcal conjugate vaccines, in numerous settings, ranging from developed to developing countries, and in infants with HIV infection and recommended the cooperation between PneumoADIP and the Hib Initiative, particularly in areas of cost benefit analysis of pneumococcal conjugate vaccine use and the feasibility of vaccine delivery to all vulnerable groups. Week. Epi. Rec. 2006 Jan; 81(1): 1-12.

Immunization Funds and Impact Assessment: New Delhi, December 7-9, 2005 - A study presented at the GAVI Partners’ Meeting covered the potential impact that immunization can have over the next decade and the funding required for this impact in developing countries. The World Health Organization (WHO) and the United Nations’ Children Fund (UNICEF) estimate that roughly 10 million additional lives could be saved through child and maternal immunization from 2006 to 2015 at an average annual cost of $10 billion. In order to reach this goal the estimated $2.5 billion current annual spending on immunization in the 72 poorest countries which have a Gross National Income of less than $1000 per year would need to increase to $3.5 billion by 2010 and $4.0 billion by 2015. The increase in funds will be used to purchase vaccines, to expand coverage of underused vaccines, to upgrade immunization delivery systems and strategies, and support immunization campaigns. The objective is to reach 90% coverage by 2015 from less than 70% at present. To learn more about this December event, please visit the GAVI Alliance website.

Progress in Child Survival: London, December 13-15, 2005 - At an international conference entitled “Tracking Progress in Child Survival: Countdown to 2015" experts assessed progress toward intervention and reductions in global child mortality. Barriers to such progress and possible solutions were identified, as well as mechanisms to hold governments and partners accountable to their commitment to save the lives of 30 million children under five years of age over the next decade. Progress toward achieving the Millennium Development Goal for Child Survival (MDG4), were assessed in 60 target nations where 94% child deaths under five years of age occur. Key findings from this report indicate that 7 of the 60 target countries are on track to meet the millennium target, and 17 countries will only meet the target if they attain a massive annual rate reduction of at least 10 per 1000 live births. Immunization and treatment of pneumonia were cited as crucial interventions that require universal coverage in order to effectively achieve the projected reduction in childhood mortality. The report was produced by the Bellagio Study Group, UNICEF and the World Health Organization. Visit: http://www.childsurvivalcountdown.com/

Defining the Clinical Impact of PCV-7. Surveillance data in the US have shown a dramatic decline in invasive pneumococcal disease incidence, at the regional as well as national level, since licensure of the PCV-7 vaccine in 2000. However since many cases of pneumococcal disease occurred in conjunction with occult bacteremia in children, with rare progression to conditions that lead to hospitalization of children, the correlation between PCV-7 and invasive pneumococcal disease-related hospitalizations has been unclear. A recent study was able to estimate the rates of hospital discharge for children and adults admitted with invasive pneumococcal disease, defined as meningitis or bacteremia caused by S. pneumoniae, using data from the 1998-2003 National Hospital Discharge Survey as well as population estimates from the National Center for Health Statistics. While a national decline in hospital discharge rates was observed during the 6-year period in children and adults admitted with invasive pneumococcal disease, rates of hospital discharge for pneumococcal bacteremia were significantly lower during the post PCV-7 licensure period in individuals 65 years of age or older, but not in children less than 4 years of age. Shah et al, Clin. Infect. Dis. 2006 Jan; 42: 1438-1444.

Novel Markers to Estimate PCV Efficacy. Levels of C-reactive protein (CRP) and/or procalcitonin were found to be a useful measure of PCV-9 vaccine efficacy and its impact against the burden of pneumonia, compared with chest radiograph-confirmed alveolar consolidation (CXR-AC) in patient participating in Phase III PCV efficacy trial in South Africa. Researchers found that CRP levels can be used as an adjunct marker of pneumococcal pneumonia to improve the specificity of measuring PCV-9 vaccine efficacy. Importantly CRP and procalcitonin measurements improved the specificity of detecting pneumococcal pneumonia in the absence of CXR-AC for children with clinically diagnosed lower respiratory tract infection (C-LRTI). The addition of CRP measurements may ameliorate PCV efficacy evaluation and may be a more cost-effective tool for studies of pneumococcal disease burden in developing countries. This study was conducted by researchers at the University of Witwatersrand in South Africa and at Emory University in Atlanta , and was cofunded by the WHO and PneumoADIP. Madhi et al, Ped. Infect. Dis. 2006 Jan; 25(1): 30-36.

If you would like to share meeting dates or any other news with PneumoADIP, please contact Benedicta Kim, hekim@jhsph.edu

Pneumococcal Network Investigators Meeting
February 13-16, 2006
Colombo, Sri Lanka
PneumoADIP and WHO are coordinating this annual conference to bring together over 70 experts from public and private sectors around the world to focus on pneumococcal disease and prevention.

ISPPD-5
April 2-6, 2006
Alice Springs, Australia
http://www.isppd5.com/