Pneumococcal conjugate vaccine use during humanitarian crises

Kevin van Zandvoort*, Francesco Checchi, Emma Diggle, Rosalind M. Eggo, Kartini Gadroen, Kim Mulholland, Catherine R. McGowan, Olivier Le Polain De Waroux, V. Bhargavi Rao, Catherine Satzke, Stefan Flasche

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

2 Citations (Scopus)

Abstract

Streptococcus pneumoniae is a common human commensal that causes a sizeable part of the overall childhood mortality in low income settings. Populations affected by humanitarian crises are at especially high risk, because a multitude of risk factors that are enhanced during crises increase pneumococcal transmission and disease severity. Pneumococcal conjugate vaccines (PCVs) provide effective protection and have been introduced into the majority of routine childhood immunisation programmes globally, though several barriers have hitherto limited their uptake during humanitarian crises. When PCV coverage cannot be sustained during crises or when PCV has not been part of routine programmes, mass vaccination campaigns offer a quick acting and programmatically feasible bridging solution until services can be restored. However, we currently face a paucity of evidence on which to base the structure of such campaigns. We believe that, now that PCV can be procured at a substantially reduced price through the Humanitarian Mechanism, this lack of information is a remaining hurdle to PCV use in humanitarian crises. Considering the difficulties in conducting research in crises, we propose an evidence generation pathway consisting of primary data collection in combination with mathematical modelling followed by quasi-experimental evaluation of a PCV intervention, which can inform on optimal vaccination strategies that consider age targeting, dosing regimens and impact duration.

Original languageEnglish
Pages (from-to)6787-6792
Number of pages6
JournalVaccine
Volume37
Issue number45
DOIs
Publication statusPublished - 23 Oct 2019

Bibliographical note

Funding Information:
KvZ, FC, CS and KM are supported by Elrha’s Research for Health in Humanitarian Crises (R2HC) Programme , which aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. The R2HC programme is funded by the UK Government (DFID), the Wellcome Trust, and the UK National Institute for Health Research (NIHR).

Funding Information:
RME acknowledges funding from an HDR UK Innovation Fellowship (grant MR/S003975/1 ).

Funding Information:
SF was supported by a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and Royal Society (grant number 208812/Z/17/Z ).

Funding Information:
KvZ, FC, CS and KM are supported by Elrha's Research for Health in Humanitarian Crises (R2HC) Programme, which aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. The R2HC programme is funded by the UK Government (DFID), the Wellcome Trust, and the UK National Institute for Health Research (NIHR). SF was supported by a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and Royal Society (grant number 208812/Z/17/Z). RME acknowledges funding from an HDR UK Innovation Fellowship (grant MR/S003975/1). CS is supported by an Australian NHMRC Career Development Fellowship (1087957) and a Veski Inspiring Women Fellowship. MCRI is supported by the Victorian Government's Operational Infrastructure Support Program. The UK Public Health Rapid Support Team is funded by the National Institute for Health Research and the Department of Health and Social Care. The views expressed are those of the authors and not necessarily those of the NIHR or DHSC. The funders had no involvement in the conceptualization, research, or writing of the manuscript. The corresponding author had final responsibility for the decision to submit for publication.

Funding Information:
The UK Public Health Rapid Support Team is funded by the National Institute for Health Research and the Department of Health and Social Care. The views expressed are those of the authors and not necessarily those of the NIHR or DHSC.

Funding Information:
CS is supported by an Australian NHMRC Career Development Fellowship ( 1087957 ) and a Veski Inspiring Women Fellowship . MCRI is supported by the Victorian Government’s Operational Infrastructure Support Program .

Publisher Copyright:
© 2019 The Authors

Keywords

  • Humanitarian crises
  • Humanitarian health
  • Internally displaced people
  • Pneumococcal conjugate vaccine
  • Pneumonia
  • Refugees
  • Vaccination strategy

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