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Johns Hopkins Bloomberg School of Public Health

Vaccine Impact: South Africa

Life-Saving Potential for HIV-Positive Children

In Soweto, South Africa, a 9-valent pneumococcal conjugate vaccine trial demonstrated that the vaccine can protect HIV infected children from serious, often antibiotic resistant cases of pneumococcal disease and has the potential to make a major health impact. The vaccine was 83% effective in non HIV-infected children and 65% effective in HIV-infected children. The fact that this vaccine is effective in HIV-infected children is great news. HIV-infected children have up to 40 times the risk of contracting pneumococcal disease compared to non-HIV-infected children. HIV-infected children are not only at increased risk of contracting pneumococcal disease but also at increased risk of suffering severely and dying from the disease once they contract it. Developing countries have both the highest burden of HIV and the highest burden of pneumococcal disease a combination that is crippling, deadly, and unjust. With broader adoption of the existing pneumococcal vaccines the world has an opportunity to help mitigate global health disparities and save the lives of millions of children.

The vaccine also significantly reduced antibiotic-resistant cases of invasive pneumococcal disease (IPD). This means that a vaccine program bolsters the second line of defense against the disease, improving our ability to treat it. For children who do contract pneumococcal disease in spite of the vaccination program, treatment with antibiotics will be more effective. This is important because in many of the countries where IPD is the most prevalent, antibiotic resistance is a common and growing problem, with some common strains resistant to multiple antibiotics.