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    Brazil Mulls Introducing Anti-pneumococcal Vaccine

    By Keith R | October 12, 2007

    Topics: Health Issues | No Comments »

          
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    Temas Foreword: A few months back, I did a post about the Latin American and Caribbean (LAC) nations debating whether they should adopt a region-wide vaccination program against pneumococcal disease, and if so, when and which vaccine to opt for. More specifically, they debated whether it was more costly to vaccinate or not to vaccinate, since each option implies different health costs. Since then, Costa Rica has chosen to proceed, while Brazil (read below) has chosen to study the matter in greater depth before committing.

    ______________________________

    From the Pan American Health Organization (PAHO):

    Research to establish extent of pneumococcal disease in Brazil

    Studies will reveal number of pneumonia cases which can be prevented with vaccination

    Before introducing a vaccine against pneumococcal disease – responsible for the deaths of one million children each year worldwide – it is vital that countries in Latin and Central America, as well as the Caribbean determine the extent of the disease among their populations, said the Pan American Health Organization (PAHO) Chief of Immunization Cuahtemoc Ruiz Matus yesterday in São Paulo. The announcement was made during the National Surveillance Symposium: Pneumococcus and Influenza, which started this Thursday in São Paulo.

    Among the countries mentioned by Matus, only Costa Rica has made the decision to introduce a vaccine against the bacteria that causes the majority of deaths from pneumonia and meningitis in the world’s poorest nations. Brazil is implementing surveillance and conducting studies to assess the extent of the killer disease in order to gather epidemiologic data. Only with this data, and with the results of a cost-benefit analysis, will the government decide how and when to introduce a vaccine.

    Preliminary results of two studies aimed at detection of the extent of bacterial pneumonia caused by Streptococcus pneumoniae, performed by different scientists in Goiânia (Goiás) and Salvador (Bahia), were presented at the symposium held by the Ministry of Health, with support from PAHO, the Sabin Institute, PneumoADIP and the US Centers for Disease Control and Prevention (CDC). Their work may serve as models for the rest of the country, assisting the government in establishing a framework in advance of any decision regarding introduction of a vaccine.

    Brazilian studies aimed at detecting the extent of pneumococcal disease are not yet conclusive, but already reveal interesting findings. Researchers found, for example, that the highest rate of pneumonia among children under two years of age in the municipality of Goiânia occurs within the poorer populations, according to the study carried out by Ana Lúcia Andrade, professor at the Federal University of Goiás.

    In Salvador, research suggests that 20% of pneumonia cases in children under five were caused by the bacteria, according to the study coordinated by Cristina Nascimento Carvalho, of the Bahia School of Medicine.

    Immunization

    Immunizing children is the most effective means of preventing the many diseases caused by pneumococcal disease. A report released last year about the impact of the bacteria in Latin America estimated that an effecitve vaccine—only one is currently available for children—could save approximately nine thousand lives each year in the region, half the annual number of deaths. The vaccine is not effective against some of the more common strains identified in the Americas. However it could ensure some herd immunity, protecting the elderly from the disease. It could also prevent as many as 678 thousand cases of ear infections, 176 thousand cases of pneumonia, two thousand cases of sepsis and 660 cases of meningitis throughout Latin America.

    Some international laboratories have vaccines that cover between 10 and 13 strains of S. pneumoniae, which should be brought to market within the next three years. In Brazil, two research instutitions, the Butantã Institute in São Paulo and FIOCRUZ in Rio de Janeiro, are also developing anti-pneumococcal vaccines at an estimated cost of production far lower than that of other laboratories. Brazilian vaccines are, however, still in the initial stages of development. One clinical trial is expected to start in 2009, according to Luciana Cezar Cerqueira Leite, a vaccine researcher at the Butantã Institute.

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