An evaluation of emerging vaccines for childhood pneumococcal pneumonia
Julia Webster,Evropi Theodoratou,Harish Nair,Harish Nair,Ang Choon Seong,Lina Zgaga,Tanvir M. Huda,Hope L. Johnson,Shabir A. Madhi,Craig E. Rubens,Jian Shayne F Zhang,Shams El Arifeen,Ryoko Krause,Troy Jacobs,Abdullah Brooks,Abdullah Brooks,Harry Campbell,Igor Rudan,Igor Rudan +18 more
TLDR
Improved SP vaccines are a very promising investment that could substantially contribute to reduction of child mortality world-wide.Abstract:
Background: Pneumonia is the leading cause of child mortality worldwide. Streptococcus pneumoniae (SP) or pneumococcus is estimated to cause 821,000 child deaths each year. It has over 90 serotypes, of which 7 to 13 serotypes are included in current formulations of pneumococcal conjugate vaccines that are efficacious in young children. To further reduce the burden from SP pneumonia, a vaccine is required that could protect children from a greater diversity of serotypes. Two different types of vaccines against pneumococcal pneumonia are currently at varying stages of development: a multivalent pneumococcal conjugate vaccine covering additional SP serotypes; and a conserved common pneumococcal protein antigen (PPA) vaccine offering protection for all serotypes. Methods: We used a modified CHNRI methodology for setting priorities in health research investments. This was done in two stages. In Stage I, we systematically reviewed the literature related to emerging SP vaccines relevant to several criteria of interest: answerability; efficacy and effectiveness; cost of development, production and implementation; deliverability, affordability and sustainability; maximum potential for disease burden reduction; acceptability to the end users and health workers; and effect on equity. In Stage II, we conducted an expert opinion exercise by inviting 20 experts (leading basic scientists, international public health researchers, international policy makers and representatives of pharmaceutical companies). The policy makers and industry representatives accepted our invitation on the condition of anonymity, due to sensitive nature of their involvement in such exercises. They answered questions from CHNRI framework and their “collective optimism” towards each criterion was documented on a scale from 0 to 100%. Results: The experts expressed very high level of optimism (over 80%) that low-cost polysaccharide conjugate SP vaccines would satisfy each of the 9 relevant CHNRI criteria. The median potential effectiveness of conjugate SP vaccines in reduction of overall childhood pneumonia mortality was predicted to be about 25% (interquartile range 20-38%, min. 15%, max 45%). For low cost, cross-protective common protein vaccines for SP the experts expressed concerns over answerability (72%) and the level of development costs (50%), while the scores for all other criteria were over 80%. The median potential effectiveness of common protein vaccines in reduction of overall childhood pneumonia mortality was predicted to be about 30% (interquartile range 26-40%, min. 20%, max 45%). Conclusions: Improved SP vaccines are a very promising investment that could substantially contribute to reduction of child mortality world-wide.read more
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Soil Contamination in China: Current Status and Mitigation Strategies
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Igor Rudan,Katherine L. O'Brien,Harish Nair,Li Liu,Evropi Theodoratou,Shamim Qazi,Ivana Lukšić,Christa L Fischer Walker,Robert E. Black,Harry Campbell +9 more
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Ending preventable child deaths from pneumonia and diarrhoea by 2025. Development of the integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea
Shamim Qazi,Samira Aboubaker,Rachel MacLean,Olivier Fontaine,Carsten Mantel,Tracey Goodman,Mark Young,Peggy Henderson,Thomas Cherian +8 more
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References
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Global, regional, and national causes of child mortality in 2008: a systematic analysis
Robert E. Black,Simon Cousens,Hope L. Johnson,Joy E Lawn,Igor Rudan,Diego G. Bassani,Prabhat Jha,Harry Campbell,Christa L Fischer Walker,Richard E Cibulskis,Thomas P. Eisele,Li Liu,Colin Mathers +12 more
TL;DR: New estimates for 2008 of the major causes of death in children younger than 5 years in 193 countries are reported to help to focus national programmes and donor assistance.
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Katherine L. O'Brien,Lara J. Wolfson,James P. Watt,Emily Henkle,Maria Deloria-Knoll,Natalie McCall,Ellen Lee,Kim Mulholland,Orin S. Levine,Thomas Cherian +9 more
TL;DR: The burden of pneumococcal pneumonia is measured by applying the proportion of pneumonia cases caused by S pneumoniae derived from efficacy estimates from vaccine trials to WHO country-specific estimates of all-cause pneumonia cases and deaths, using disease incidence and case-fatality data from a systematic literature review.
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A trial of a 9-valent pneumococcal conjugate vaccine in children with and those without HIV infection.
Keith P. Klugman,Keith P. Klugman,Shabir A. Madhi,Robin E. Huebner,Robert Kohberger,Nontombi Marylucy Mbelle,Nathaniel F. Pierce +6 more
TL;DR: Vaccination with a 9-valent pneumococcal conjugate vaccine reduced the incidence of radiologically confirmed pneumonia among children with and those without HIV infection.
Journal ArticleDOI
Efficacy of nine-valent pneumococcal conjugate vaccine against pneumonia and invasive pneumococcal disease in The Gambia: randomised, double-blind, placebo-controlled trial
Felicity T. Cutts,Syed M. A. Zaman,Godwin Enwere,Shabbar Jaffar,Orin S. Levine,Orin S. Levine,J. B. Okoko,Claire Oluwalana,Adeola Vaughan,Steven Obaro,Amanda Leach,Keith P. W. J. McAdam,Ekow Biney,Mark Saaka,U. Onwuchekwa,Fred G. Yallop,Nathaniel F. Pierce,Brian Greenwood,Richard A. Adegbola +18 more
TL;DR: Pneumococcal conjugate vaccine has high efficacy against radiological pneumonia and invasive pneumococcal disease, and can substantially reduce admissions and improve child survival in this rural African setting.
Journal ArticleDOI
Which Pneumococcal Serogroups Cause the Most Invasive Disease: Implications for Conjugate Vaccine Formulation and Use, Part I
TL;DR: Each conjugate formulation could prevent a substantial IPD burden in each region and age group, including Europe, except the United States and Canada and Oceania.