VACCINES SHOULD BE AT FOREFRONT IN CHILD HEALTH

       Paediatricians and health experts at an international conference have called for pneumococcal conjugate vaccine to be added to the country's routine immunisation program, as the World Health Organisation has reported pneumonia kills two million children under five annually - one death every 15 seconds. The three-day event, titled "Asian Vaccine Conference 2009", last ended Saturday with the signing of the "Siem Reap Declaration".
       It called for policy-makers, academics, the pharmaceutical industry and others to put vaccination at the forefront of child protection - and to put under-utilised vaccines such as those of pneumococcal, haemophilus influenzae type-b (Hib), and rotavirus into a national immunisation program (NIP).
       Dr Lulu C Bravo, chairwoman of the Asian Strategic Alliance for Pneumococcal Disease Prevention, said half the under-five deaths from pneumonia came from an infection with bacteria called streptococcus pneumoniae, leading to invasive pneumococcal diseases (IPDs) such as blood infection and meningitis. Most kids with severe IPDs become disabled and often die.
       Citing the 2004 WHO death rate figures among under-five children, she said pneumonia was the number one killer at 19 per cent followed by diarrhoea at 17 per cent and IPDs at 10 per cent. Bravo said the first and second killers were vaccine-preventable.
       "Every child needs to be protected and it's their right (to be vaccinated)," she said adding this would be in line with the Millennium Development Goals' two-thirds reduction in child mortality by 2015.
       "Vaccines cannot be considered as 'costs' but 'investments' to create quality children for a country's future," Bravo said.
       The pneumococcal conjugate vaccine was included in the US immunisation programme for under-five children in 2000. The infection ratio of 80 to every 100,000 toddlers declined to 4.6 in 2003, a 94-per-cent drop.
       Out of 92 countries with the vaccine available for sale, 39 have included it in their NIPs. Hong Kong will be the first in the Asia-Pacific region to introduce the vaccine as part of its programme, from September 1.
       Thailand currently has this vaccine as an alternative for parents to buy for infants at Bt3,000-Bt3,500 per shot. The four-shot schedule begins at two months, followed by more shots at four, six and 12-15 months.
       Royal College of Paediatricians president Somsak Lolekha said the vaccine also benefited unvaccinated people, especially the pneumonia-prone group over 65. It also reduced the number of pneumococcal patients with penicillin resistance (by 98 per cent among under-two children and 79 per cent of over-65 persons).
       Besides vaccination, parents can protect their children by teaching them good hygiene (especially frequent hand washing and covering nose and mouth when sneezing), by breast-feeding infants and by consulting doctors about immunity boosting.
       New pneumococcal conjugate vaccines - PCV-10 and PVC-13 - are coming soon. PCV-10, which boosts immunity against haemophilus influenzae and could immunise 80 per cent of Thais, is being registered with the Thai Food and Drug Administration. PVC-13 could immunise 90-95 per cent of Thais and its registration with the US FDA is underway, he added.
       If the government included vaccines in its immunisation programme, pharmaceutical companies would stampede to offer products and the price would drop, Somsak said. He suggested countries in the region come together for better bargaining to buy the vaccine in large lots at the lowest price.
       Bangkok Metropolitan Administration (BMA) deputy governor Dr Malinee Sukvejchaworakij attended the conference. The BMA launched a pilot project supplying PCV-7 to some 100 children born on December 5 last year and reportedly has in the pipeline a similar project to provide the vaccine to "risky children" (such as those born underweight or with heart disease).