London: An Indian government programme to vaccinate 27 million new-born babies against pneumococcus could prevent approximately 35,000 under-five pneumonia deaths, according to a new worldwide study.
Researchers at the University of Strathclyde in the UK and the Center for Disease Dynamics Economics and Policy in the US and India conducted the joint research to predict the potential outcome and cost-effectiveness of the new vaccination programme.
The Indian government is currently rolling out a pneumococcal conjugate vaccine (PCV) across the country to tackle the disease, which claimed the lives of an estimated 105,000 children under the age of five in 2010.
However, the vaccine is significantly more expensive than others included in India’s Universal Immunisation Programme. In addition, its effectiveness in low and middle-income countries remains uncertain.
The Global Alliance for Vaccines and Immunisation is currently helping to fund PCV provision until 2021, after which the Indian government will have to bear the full costs.
The study, published this week in the journal ‘BMJ Global Health’, concludes the programme could prevent 34,800 under-five deaths, cost $ 240 million (Rs 1,600 crore) and save families $ 48.7 million in treatment costs annually.
“Pneumonia is a major cause of death in India and as many other countries have done the government decided to introduce PCV in its vaccination programme,” says Dr Itamar Megiddo, Assistant Professor and Chancellor’s Fellow at Strathclyde Business School and lead author of the research.
“However, 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 contextualised 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,” he notes.
Megiddo said that while their study had its limitations due to data gaps, but even with conservative assumptions they believe the vaccination would avert a significant number of deaths.
He added: “It would also protect some of the poorest people in India from potentially catastrophic expenditure and deliver value for money. We would recommend the Indian government includes 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.”
This research outcome assumed vaccination coverage levels similar to those achieved by the diphtheria, pertussis and tetanus (DPT) immunisation programme, approximately 77 per cent.
Increasing the coverage level to 90 per cent was found to be the most cost-effective outcome in over 95 per cent of simulated outcomes.
The researchers used a model they had previously developed and validated called IndiaSim, which is representative of the Indian population and health system. The analysis considered the distribution of the dominant strains of pneumonia in India and the characteristics and behaviour of the host population within the country’s health system.
The study was funded by the Bill & Melinda Gates Foundation through the Global Antibiotic Resistance Partnership and supported by Princeton University through its Grand Challenges Program.
