Vaccination can help improve the health equity of those who are HIV positive. – VoICE
Key Concept

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.

Sigauque B, Moiane B, Massora S et al. 2018. Early declines in vaccine type pneumococcal carriage in children less than 5 years old after introduction of 10-valent pneumococcal conjugate vaccine in Mozambique. Pediatric Infectious Disease Journal . 37(10).
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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.

Bigogo GM, Audi A, Auko J et al. 2019. Indirect effect of 10-valent pneumococcal conjugated vaccine against adult pneumococcal pneumonia in rural Western Kenya. Clinical Infectious Diseases.
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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.

Zar, H.J. and Madhi, S.A. 2008. Pneumococcal conjugate vaccine – a health priority. South African Medical Journal. 98(6).
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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.

Madhi, S.A., Kuwanda, L., Cutland, C., et al. 2005. The impact of a 9-valent pneumococcal conjugate vaccine on the public health burden of pneumonia in HIV-infected and -uninfected children. Clinical Infectious Disease. 40(10).
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