Pneumonia and meningitis account for nearly one in three child deaths in Pakistan every year. A four-year study of the impact of the Pneumococcal Conjugate Vaccine (PCV-10) has found that the vaccine prevents children from contracting deadly strains of the two diseases.
The study, funded by the Global Alliance for Vaccines and Immunization (GAVI) and conducted by researchers from Aga Khan University (AKU), investigated the impact of PCV-10 in Karachi, Hyderabad, Matiari and Thatta.
Researchers found that the vaccine was 70 percent effective in protecting children from ten strains of pneumonia and meningitis.
In addition to studying the vaccine’s effectiveness, researchers also analysed factors affecting the coverage of the vaccine in Thatta and Tando Muhammad Khan, two rural districts of Sindh - the province with one of the lowest rates of immunisation coverage.
Dr Asad Ali, associate professor and director of research in paediatrics at AKU, said, “In Pakistan, pneumonia is the leading cause of death in children over the age of one month. Our study clearly demonstrates the value of making this vaccine available to every child and puts forward new recommendations that will extend the reach of the vaccine to every child, in rural and urban parts of the country.”
Speakers at the seminar also made a range of proposals to further strengthen vaccination delivery systems in the country. They called for three separate quality improvement processes to be used to keep frontline immunisation staff motivated and for low-performing field staff to be mentored through special programmes run by star performers. They also recommended changes in the way data is used to make decisions on outreach campaigns at the district and provincial level.
Dr Khalid Mehmood Ahmed Khan, professor of paediatrics at the National Institute of Child Health, said, “The PCV-10 vaccine has made a huge difference. But we are still seeing cases of meningitis and pneumonia in children who were missed in immunisation activity. The public and private sector must work together aggressively to ensure that every child receives the full course of vaccinations under the national Expanded Programme of Immunisation.”
Dr Shehla Zaidi, associate professor in paediatrics and child health at AKU and programme lead for the routine immunisation strengthening initiative, described how the university’s wide-ranging healthcare initiatives in Tando Muhammad Khan had increased the reach of four vaccines provided under the government’s EPI.
She mentioned that her team had introduced a range of game-changing initiatives into the local immunisation programme that raised awareness of vaccination drives.
“Over the course of 12 months we have seen a two-fold increase in vaccine coverage levels. We have done this by raising demand for vaccines in rural areas through radio and text message announcements. By giving fuel allowances, we have extended the reach of outreach campaigns and the use of a smartphone-based application has introduced real-time monitoring of vaccination activity.”
Dr Safi Malik, director of programmes at the Ministry of National Health Services, who leads the federal government’s programmes on preventable diseases, spoke about how lessons learnt from the national polio eradication program could help strengthen the EPI.
The PCV-10 vaccine’s rollout across Pakistan in late 2014 was enabled by a wide-ranging network of partners known as the Sindh Pneumococcal Vaccine Study Group. These included federal and provincial governments, GAVI, and participating tertiary care hospitals and universities across Sindh that analysed evidence and developed approaches to assess the vaccine’s effectiveness.
The nationwide roll-out of PCV-10 meant that a course that used to cost individuals upto Rs 16,000 is now available to all Pakistanis at no cost.