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New vaccines to reduce child deaths

The Department of Health is launching three new vaccines, expected to significantly reduce child deaths and illnesses and should be available in all public health facilities throughout the country.
The 3 new vaccines are:

  • Pneumococcal Conjugate Vaccine - 7 valent (PCV7); the current product is Prevenar
  • Rotavirus vaccine, the current product is Rotarix
  • Pentavalent Vaccine (DTaP-IPV/Hib), the current product is Pentaxim.
    • PCV7: protection against pneumonia, meningitis and others
      PCV-7 protects against severe life threatening diseases caused by a bacterium streptococcus pneumoniae, also known as pneumococcus. The group of conditions caused by this bacterium also referred to as Pneumococcal disease, are very common and can be very serious.

      The severe conditions known as Invasive Pneumococcal Disease are: pneumonia, meningitis and septicaemia/ bacteraemia. Pneumonia affects the chest and the ability to give oxygen to our bodies, meningitis affects the brain, spinal cord and related structures and septicaemia refers to a condition where bacteria multiply in the blood stream.

      The disease has serious consequences, as many will suffer severe complications like deafness, brain damage and some die. The outcome is particularly poor for those who do not get treatment.

      Diseases caused by pneumococcus affect all people, but children and particularly those below the age of 2 years are at high. Also at high risk are: the elderly, those with a weak immune system including the HIV infected and those with cancer, those with an underlying illness. Children at day care centres like crèches and preschools are more exposed.

      How can you prevent this disease?
      A vaccine for immunisation is now available to protect children from this deadly disease. The vaccine, Pneumococcal Conjugate Vaccine - 7 valent (PCV7) is available free of charge at public health facilities around the country. It is given at 6 weeks, 14 weeks and 9 months. The vaccine was introduced on the 1 April 2009 countrywide.

      Who will benefit?
      All South Africans will benefit from the introduction of PCV 7. Although the vaccine is for young children, the protection from this vaccine is for the whole population.

      This is because the vaccine will decrease the amount of disease among children who generally (even when they are healthy) carry the disease and infect others particularly the elderly and adults who are immuno-compromised, like those who have an HIV infection; all of whom are at risk of Pneumococcal disease.

      Rotavirus vaccine: protection against diarrhoea
      Rotavirus infection causes diarrhoea. Diarrhoea caused by rotavirus can be quite serious, particularly in resource poor settings leading to dehydration, electrolyte imbalance and death. This is the main problem in developing countries, as infected children may not reach hospital in time and thus are more likely to succumb to the disease.

      Who is at risk?
      All children below the age of 5 years in all countries and settings are at risk. By the time children are 5 years old, practically all of them have had at least one rotavirus infection. The disease is most severe in children below 1 year and in resource poor settings.

      How to prevent rotavirus diarrhoea?
      Immunisation with rotavirus vaccine will prevent severe forms of the disease and prevent deaths. Good hygiene practices may help, however the condition is common even in settings with excellent hygiene standards.

      Antibiotics have no effect on the infection. Treatment is mainly supportive by ensuring re-hydration and electrolytes replacement.

      Pentavalent Vaccine: protection against 5 conditions
      This vaccine is a combination vaccine with five (penta) components (antigens), protecting against 5 conditions: Diphtheria, Pertussis, Tetanus, Haemophilus influenzae and Polio. The new vaccine replaces an older combination of 4 antigens (a tetravalent), which is called Combact-Hib.

      The advantage of this vaccine lies in the Acellular Pertussis (aP) vaccine and the Injectable Polio vaccine (IPV). Acellular Pertussis (aP) vaccine is more advanced than the whole cell Pertussis vaccine currently used. It causes less side effects. Similarly the Injectable polio vaccine has no risk of causing vaccine associated paralysis, which is the main risk with oral polio vaccine currently used. Both new antigens (aP and IPV) are widely used in developed countries.

      Pentaxim will protect against these conditions:

      • Diptheria - a condition that presents with a thick infected membrane on the throat, which causes difficulty inbreathing and swallowing.
      • Pertussis - whooping cough; a highly infectious disease which presents with severe bouts of cough associated with a characteristic sound (a whoop) at the end of the cough attack made by gasping for air.
      • Tetanus - locked jaw; presents with a fit like attack associated with a hyper-extended neck, locked jaw; a large majority of those infected die.
      • Haemophilus influenzae - causes pneumonia, meningitis and septicaemia (similar to pneumococcus).
      • Polio - paralysis or weakness of any limb or limbs at times associated with paralysis of breathing muscles.

      Who should be immunised?
      All children are to be vaccinated with the Pentavalent vaccine (Pentaxim) at 6, 10, 14 weeks and at 18 months. Children who have already received some doses of the older product (Combact Hib) can be safely given Pentaxim to complete the schedule. The two are interchangeable.

      Who will benefit?
      The vaccine will prevent the 5 conditions in the most vulnerable group, the children. However, all South Africans will benefit from this vaccine as diseases are prevented and there is decreased circulation of these organisms which affect older age groups as well.

      Immunisation is free

      • Immunisation is free in all public health facilities in this country, including the new vaccines.
      • Immunisation prevents more than 3 million deaths a year and will prevent even more as more and more children are protected with new vaccines.
      • HIV infected children who do not have AIDS should be vaccinated. They need protection more than HIV uninfected children.

      (Health24, July 2009)

      References:
      Vaccine facts sheet for Immunisation Awareness Week from Department of Health

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