Pneumonia vaccine expensive, but still good for India, says study

PSV could save more than 34,000 children under the age of five, says the study

In 2010, pneumococcal pneumonia accounted for 30 per cent of pneumonia-related deaths in children under five in India | Reuters In 2010, pneumococcal pneumonia accounted for 30 per cent of pneumonia-related deaths in children under five in India | Reuters

Despite issues over its high cost, the Pneumococcal Conjugate Vaccine (PCV) could save more than 34,000 children under the age of five, says a new study. The PCV is part of the Centre's Universal Immunisation Programme (UIP) to tackle the pneumococcal disease that caused the deaths of an estimated 105,000 children under the age of five in 2010. 

According to the results of the study, published in the journal, BMJ Global Health, the Centre's PCV programme that costs Rs 1,600 crore could save 34,800 children under five, and in turn, help their families save on treatment costs, too. 

The vaccine was launched in May last year by Union Minister for Health and Family Welfare Jagat Prakash Nadda. It was seen as an important addition in the UIP, because pneumonia kills more under five-year-old children than any other infectious disease does. India accounts for nearly 20 per cent of global pneumonia deaths in this age group.  

In 2010, pneumococcal pneumonia accounted for about 16 per cent of all severe pneumonia cases, and 30 per cent of pneumonia-related deaths in children under five in India. 

However, the vaccine is significantly more expensive than others included in the UIP, according to authors of the study. In addition, its effectiveness in low and middle-income countries is uncertain, they say. The Global Alliance for Vaccines and Immunization (GAVI) is currently helping to fund PCV provisions until 2021, after which the Indian Government will have to bear the full costs.

In the past too, public health experts have raised concerns about the vaccine's efficacy, especially for a country such as India. 

To predict the potential outcome and cost-effectiveness of the vaccine programme, researchers at the University of Strathclyde in the UK and the Center for Disease Dynamics Economics and Policy in the US and in New Delhi used a model they had previously developed and validated called “IndiaSim”, which is representative of the Indian population and health system. Their analysis considered the distribution of the dominant strains of the disease in India and the characteristics and behaviour of the host population within the country’s health system.

The study's lead author, Dr Itamar Megiddo, assistant professor and chancellor's fellow in Strathclyde Business School said, “PCV is expensive and its efficacy is uncertain for a number of reasons. These include a lack of information on the distribution of the disease-causing strains in India and lack of contextualized information on the efficacy of the vaccine in India and other low- and middle-income countries. The affordability and cost effectiveness for a country like India is especially important.” 

Megiddo said that though the study (funded by Bill and melinda Gates Foundation) had limitations and there are data gaps that need to be filled, researchers still believe the vaccination would avert a “significant number of deaths”.

“We would recommend the Indian Government include PCV vaccination in the Universal Immunisation Programme, and the vaccine’s effectiveness should be continuously monitored as it is rolled out to provide more data to inform vaccination strategy,” he said.

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