Vaccines can decrease illness and death

"It is imperative for parents to realise the importance of correct and timely vaccination, as this could make a difference to a child's quality of life", says Dr Pieter Snyman, a paediatrician in private practice.

He explains while some fortunate patients in industrialized countries are likely to benefit from cutting-edge technology and research such as stem cell transplantation, newer novel medication and improved organ transplantation survival rates, sadly many developing countries still lack the most basic health care.

“Research has shown that simple, relatively low-cost measures such as providing adequate nutrition and vaccinations can dramatically decrease mortality, especially in the young.”

In order to address this disparity in health care between the west and the “rest”, health-related millennium development goals (MDG) were set to improve health and general living conditions in developing countries.

According to Dr Snyman, goal four of the MDG is to reduce the under-five mortality rate by two-thirds between 1990 and 2015. World Health Organisation (WHO) statistics show pneumonia kills more children (19%) than any other illness, according to the under-five mortality figures. This is more than AIDS (3%), malaria (8%) and measles (4%) combined. Furthermore it is known that malnutrition is implicated in 53% of these mortalities.

“One is quick to forget about the disabilities once caused by infectious diseases, now preventable through vaccines. Anecdotes from grandparents and older colleagues about the horrible suffocating deaths witnessed from diphtheria is one of the grim reminders of the pre-vaccine era. Another example is that of wheelchair-bound people who did not receive the benefit of polio immunisation.”

Despite the overwhelming scientifically proven benefits of vaccinations, there are unfortunately some parents who deliberately deny their children the opportunity of immunisation. Snyman says we live in an era where the practice of complimentary and alternative medicine seems to be increasing. Homeopathic "immunisation" to some parents seems to be a "safe" alternative way of "immunising" their children.

This however is where the great danger lies explains Snyman. “Although many children remain perfectly healthy despite not being vaccinated, this is only because of herd immunity, in other words where the majority of the population are vaccinated and protect the vulnerable who are no not vaccinated. If vaccine coverage falls below a certain threshold it will not be long before we see a resurgence of infectious diseases.”

In the last decade or so numerous new vaccines have become available, helping in the ongoing battle against infectious diseases. These include vaccines protecting against rotavirus gastroenteritis human papilloma virus (HPV) which can cause cervical cancer and a vaccine against pneumococcal disease.

“Pneumococcal disease is an important cause of mortality worldwide. The leading cause of severe pneumonia in children in developing countries is Streptococcus pneumoniae (bacterium). Each year more than two million children under five die of pneumonia in the developing world.“

Immune deficiencies, including HIV, which is highly prevalent in South Africa - greatly increases the likelihood of contracting pneumococcal disease.

“Alarmingly, worldwide there is growing resistance of Streptococcus pneumoniae to commonly used antibiotics. One of the most important reasons for this is the so called prescription pressure from parents and patients, for doctors to prescribe antibiotics for viral upper respiratory infections, coughs and colds.”

All this underlines the urgent need to use vaccines for preventing pneumococcal disease.

Prevenar is a vaccine available in South Africa, which has been licensed in more than 45 countries, and has also been included in more than 20 national immunisation programmes including Australia, the UK and recently New Zealand.

Along with providing adequate nutrition, reducing indoor pollution and improved vaccination coverage against measles, Haemophilus influenzae and Streptococcus pneumoniae will be one of the important strategies to combat the forgotten burden of pneumonia.

The old adage "prevention is better than cure" does not ring truer than when it comes to vaccination. To quote one of the world's leading experts on vaccination, Professor Stanley Plotkin: "The impact of vaccination on the health of the world's people is hard to exaggerate. With the exception of safe water, no other modality, not even antibiotics, has had such a major effect on mortality reduction and population growth.”