VoICE Immunization Evidence: Health inequity

Key Idea

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. 98:463-7.

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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. 40:1511-8.

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