The PCV-13 vaccine may increase the susceptibility of antibiotic-resistant bacteria strains

A community-based study in Vietnam found a high percent of children under five years of age were carrying pneumococcal bacteria in their noses and throats that were non-susceptible to commonly-used antibiotics. Of the strains tested, 18% were not susceptible to penicillin, 26% weren’t susceptible to cefotaxime, 76% were not susceptible to meropenem and 14% were not susceptible to all three nor to any of the “macrolide” drugs (e.g., erthromycin and azithromycin). However, 90% of the multi-drug resistant strains are serotypes that are in the 13-strain pneumococcal conjugate vaccine (PCV-13) and thus the introduction of a vaccine is expected to increase the susceptibility of circulating strains of the bacteria.

Dengue illness is costly for low-income families, but immunization can help reduce the economic burden

In a standardized survey of the costs of dengue illness in three highly endemic countries, the economic burden of dengue was greatest on Vietnamese and Colombian low-income families, whose total costs, including lost wages, outpatient and inpatient cases combined, average 36-45% of their monthly household income. In Thailand, although significant, the economic burden was 17% less than the other countries, due to Thailand’s universal health insurance system.

Immunizing infants and older age groups against typhoid can save costs and be economically justifiable

The first study of the cost-effectiveness of typhoid conjugate vaccines found that routinely immunizing infants at 9 months of age would actually save costs in 2 settings (Delhi, India and a rural area of Vietnam), due to high incidence or high hospitalization rates, and would be cost-effective in the study’s 3 other sites (in India and Kenya). Adding a one-time catch-up campaign for various older age groups would still save costs in Delhi and Vietnam, and increase the cost-effectiveness in the others, making it economically justifiable.

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