Key Evidence: Within two years of the introduction of PCV10 in Mozambique, the percent of vaccinated children under five years of age with nasopharyngeal carriage of vaccine strains, declined equally in HIV-infected as in HIV-uninfected children. The vaccine-type carriage rates among both HIV-infected and uninfected vaccinated children after the vaccine was introduced were similar.
From the VoICE Editors: Pneumococcal nasopharyngeal carriage can be a precursor of invasive pneumococcal disease.
Key Evidence: Over a five-year period following the introduction of PCV for infants in Kenya, the incidence of pneumococcal pneumonia in adults with HIV in a rural area fell sharply — narrowing the gap in incidence rates between HIV-infected and non-infected adults — as a result of both the herd effects of the vaccine and improved access to HIV care during this period.
Key Evidence: A review of evidence for the use of pneumococcal conjugate vaccine in South Africa showed that children who are HIV positive are at significantly increased risk of pneumococcal disease, and so will benefit the most from vaccination, despite decreased vaccine efficacy in this group compared to healthy children.
Key Evidence: A large randomized controlled trial of a pneumococcal conjugate vaccine in South Africa found that use of the vaccine prevented 10 times as many cases of pneumococcal pneumonia in HIV positive children than in HIV negative children.