Boosting immunisation against pneumonia
Dr. Bamigboje Olatomi is a consultant paediatrician and Medical Director of Lagoon Hospital, Awolowo Road Ikeja, Lagos. In a chat with journalists ahead of the World Pneumonia Day (WPD), November 12, she decried a situation where Nigeria is one of the five countries with highest number of children that have not been vaccinated against pneumonia and deaths among under-five. The paediatrician with special interest in respiratory ailments spoke on how to improve immunization against pneumonia and other childhood killer diseases. CHUKWUMA MUANYA, Assistant Editor, was there. Excerpts:
A recent report by the International Vaccine Access Center (IVAC) and World Health Organisation (WHO) Nigeria and five other countries ranked high with children that are not vaccinated. How can this situation be addressed?
The main reason why we should improve pneumococcal vaccination rates in Nigeria will be that instead of being penny-wise pound foolish we are going to be pound wise because when you give the immunization, you have less children coming down with the invasive pneumococcal disease and so our spending on health will be reduced. The under-five mortality is going to be reduced because it is a contributor. The effect of absenteeism in schools is going to be reduced, when a child is admitted a parent has to stay with the child in the Hospital. The parent has to run around, the same parent would have been involved in other economic activities, so it is something we need to scale up…. Immunization is the cheapest form of intervention you can make to prevent vaccine preventable disease in general. It is the cheapest form; the cost of immunization is far low in comparison to the cost of having to treat a child or any individual that comes down with these vaccine-preventable diseases. Aside from reducing cost, mortality risks as well as morbidity and complications from the disease.
How do can we keep pneumonia at bay?
We need to improve access; we still have one of the lowest coverage rates in Nigeria. The report for last year, 2016, the pentavalent 3 coverage was about one out three children have completed the pentavalent vaccination.
The pentavalent vaccine is a combination of five vaccines in one: diphtheria, tetanus, whooping cough, hepatitis B and Haemophilus influenza type b (the bacteria that causes meningitis, pneumonia and otitis). So access is a big problem, we have rural communities where there are no medical facilities and the people have to travel to far distances if they are to be vaccinated. So most of them will not finish taking their immunization. Finance is another thing. We need to improve financing to make sure these vaccines are readily available and at a low cost that everyone can afford. We need to ensure that logistics for all this vaccination input in place. Our power supply is also erratic and vaccines are things that require a cold chain system. Vaccines are usually in the refrigerator. They are not things we pick from the shelf so these are all the things that came into play when we want this. The other is dissemination of information to the public, health education. We need to make use of our religious bodies, cultural bodies, traditional organization to ensure that information is adequately disseminated to the public about what vaccines are and the benefits of vaccination. We also need to take charge of the misinformation that the public has about vaccination. There is disconnect, and this reduces the impact the immunization coverage rate. The health workers need to take advantage of missed opportunities. If any child comes to a facility we should ask about their immunization history and if they have missed out on any of the immunization then it is recommended they take those immunization.
How often should one take the vaccination? Is it just once in a lifetime?
It is not just once in a lifetime, the number of doses is age dependent. For now, we have the programme on immunization in the country. The pneumococcal vaccine has already been added to the routine vaccines that are given to children and they do have their number of doses that they are supposed to take. They have three doses, for adults a shot might be enough. There are some that have other chronic illnesses that will need an extra shots to build immunity. So the number of doses is age dependent and it also depend on some medical condition and this doses are based on repeated research that have been done to establish how an individual mount the immune response to the vaccine when it is given. So for an adult that is very healthy, if he wants to take a pneumococcal vaccine, a shot will suffice. For a baby that is just born, the ages six, 10, 14 weeks is when they have their pneumococcal vaccine.
Is there any reason why some should be not be vaccinated?
Yes there are some reasons why some people should not be vaccinated, this is based on, pneumococcal vaccine may not apply because it is a live vaccine, and we have some vaccines that are live vaccines. So for some immune-compromised people like Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS), they are immune-compromised already. There is a risk to them when they are given those live vaccines for them to have the active diseases.
Aside that; there are people that have allergies to some vaccine components. For those kind of people we do not want to give vaccine when you do not know whether they have been given something before and they reacted or if on reading the components there is already something in it that the person have allergies to. It is either you look for another type of vaccine that does not have those components to give to them so that they can benefit from it.
November 12 is World Pneumonia Day. Why the focus?
World Pneumonia Day brings people from all over the world together uniting to demand that something be done to fight the pneumonia illness. World Pneumonia Day helps to highlight the severity of pneumonia and encourages more organisations to look at ways of combating the disease. This day was first hosted in 2009 when over 100 organisations joined to form the Global Coalition against Child Pneumonia. It is marked every year on 12 November to: raise awareness about pneumonia, the world’s leading killer of children under the age of five; promote interventions to protect against, prevent and treat pneumonia; and generate action to combat pneumonia.
Pneumonia is one of the most solvable problems in global health and yet a child dies from the infection every 20 seconds. Together we can ensure the fight against pneumonia is won.
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