Pneumococcal conjugate vaccine use during humanitarian crises

Zandvoort, Kevin van; Checchi, Francesco; Diggle, Emma; Eggo, Rosalind M; Gadroen, Kartini; Mulholland, Kim; McGowan, Catherine R.; Waroux, Olivier le Polain de; Rao, Bhargavi; Satzke, Catherine

doi:10.1016/j.vaccine.2019.09.038

Cited by 16 publications

(20 citation statements)

References 57 publications

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“…We randomly sampled 96 of these empty shelters and asked neighbours whether the shelter was occupied. Using this sample, we estimate that 50% (95%CI 39-60) of the shelters had been uninhabited for a long time, while 38% (28-49) of the shelters were occupied and 12% (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) were a shop or combined with another shelter already included in the survey. Using the upper bound of these estimates, we conservatively assume that there are a total of 872 unique shelters in Digaale, of which 715 are inhabited.…”

Section: Resultsmentioning

confidence: 99%

“…In the context of a project to study the effectiveness of pneumococcal conjugate (PCV) vaccination among IDPs, we aimed to parameterise a model of Streptococcus pneumoniae transmission. 15 We therefore conducted a contact and risk factor survey in an IDP camp in Somaliland in 2019 to quantify factors commonly associated with transmission of respiratory infections.…”

Section: Introductionmentioning

confidence: 99%

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Social contacts and other risk factors for respiratory infections among internally displaced people in Somaliland

Zandvoort

Bobe²,

Hassan

et al. 2021

Preprint

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Background Populations affected by humanitarian crises experience high burdens of acute respiratory infections (ARI), potentially driven by risk factors for severe disease such as poor nutrition and underlying conditions, and risk factors that may increase transmission such as overcrowding and the possibility of high social mixing. However, little is known about social mixing patterns in these populations. Methods We conducted a cross-sectional social contact survey among internally displaced people (IDP) living in Digaale, a permanent IDP camp in Somaliland. We included questions on household demographics, shelter quality, crowding, travel frequency, health status, and recent diagnosis of pneumonia, and assessed anthropometric status in children. We calculated age-standardised social contact matrices to assess population mixing, and conducted regression analysis on risk factors for recent self-reported pneumonia. Results We found crowded households with high proportions of recent self-reported pneumonia (46% in children). 20% of children younger than five are stunted, and crude death rates are high in all age groups. ARI risk factors are common, but we did not find any significant associations with self-reported pneumonia. Participants reported around 10 direct contacts per day. Social contact patterns are assortative by age, and physical contact rates are very high (78%). Conclusions ARI risk factors are very common in this population, while the large degree of contacts that involve physical touch could further increase transmission. Such IDP settings potentially present a perfect storm of risk factors for ARIs and their transmission, and innovative approaches to address such risks are urgently needed.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Social contacts and other risk factors for respiratory infections among internally displaced people in Somaliland

Zandvoort

Bobe²,

Hassan

et al. 2021

Preprint

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“…The high cost associated with PCVs remains a major impediment for their use in humanitarian immunisation programs. [11] Based on our findings, a single dose of PCV10 at 18 months could be effective during emergency situations to protect children living in extremely vulnerable conditions where multi-dose vaccination is not feasible. Such an approach has been successfully used with measles supplementary immunisation campaigns, wherein expanded target-age groups allowed for catch-up immunisations and a reduced dosing schedule.…”

Section: Discussionmentioning

confidence: 69%

“…PCV vaccination in older children could also be an important public health tool for populations affected by humanitarian crises and in other emergency settings, particularly famine where malnourished children are at very high risk of death from pneumonia. [ 11 , 12 ] WHO recommends that, during emergency situations, PCV is used in children under one and considered for use in children under five, although there are no clear guidelines on the target age, number of doses or frequency of campaigns due to a lack of evidence. [ 13 , 14 ] The COVID-19 pandemic has profoundly affected nutrition and vaccine access for the poorest children in the world[ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Immunogenicity and impact on nasopharyngeal carriage of a single dose of PCV10 given to vietnamese children at 18 months of age

Higgins

Temple

Dai

et al. 2021

The Lancet Regional Health - Western Pacific

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Background This study investigated the immunogenicity and impact on nasopharyngeal carriage of a single dose of PCV10 given to 18-month-old Vietnamese children. This information is important for countries considering catch-up vaccination during PCV introduction and in the context of vaccination during humanitarian crises. Methods Two groups of PCV-naïve children within the Vietnam Pneumococcal Project received PCV10 (n=197) or no PCV (unvaccinated; n=199) at 18 months of age. Blood samples were collected at 18, 19, and 24 months of age, and nasopharyngeal swabs at 18 and 24 months of age. Immunogenicity was assessed by measuring serotype-specific IgG, opsonophagocytosis (OPA) and memory B cells (Bmem). Pneumococci were detected and quantified using real-time PCR and serotyped by microarray. Findings At 19 months of age, IgG and OPA responses were higher in the PCV10 group compared with the unvaccinated group for all PCV10 serotypes and cross-reactive serotypes 6A and 19A. This was sustained out to 24 months of age, at which point PCV10-type carriage was 60% lower in the PCV10 group than the unvaccinated group. Bmem levels increased between 18 and 24 months of age in the vaccinated group. Interpretation We demonstrate strong protective immune responses in vaccinees following a single dose of PCV10 at 18 months of age, and a potential impact on herd protection through a substantial reduction in vaccine-type carriage. A single dose of PCV10 in the second year of life could be considered as part of catch-up campaigns or in humanitarian crises to protect children at high-risk of pneumococcal disease.

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“…WHO recently recommended to use PCV in children under 1 y of age and consider for children under 5 y of age during humanitarian crises and other emergencies. 39 Refugees and asylum seekers' perspectives on infectious disease screening and vaccination policies are another important factor for the control of VPDs. According to the study by Louka et al, among refugees from Afghanistan, Syria and Eritrea in Greece and the Netherlands, 72.1% of refugees were willing to be vaccinated after arrival in Europe, 26% preferred vaccination and screening to be performed at the point of entry.…”

Section: Meningococcal Vaccinesmentioning

confidence: 99%

Meningococcal infections among refugees and immigrants: silent threats of past, present and future

Dinleyici

Borrow

2020

Human Vaccines & Immunotherapeutics

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Globally, there is an increasing number of international migrants. The majority are forced displaced refugees and children unaccompanied by a caregiver, and have limited access to essential public health interventions. Routine vaccination might be interrupted or be incomplete due to conflict areas with limited public health services or a long-unplanned journey. Refugees and migrants may bring infectious disease risks to their country of destination and may be exposed to new risk factors during transit or at their destination. There are lessons learned strategies among refugees and asylum seekers in different countries (vaccination campaign during outbreak, maintain vaccination systems for refugees and medical screening and/or vaccination on arrival) against vaccine-preventable diseasesother than meningococcal infections. Since the 1980s, invasive meningococcal disease (IMD) has been reported as a critical healthcare issue in places of humanitarian crisis such as Thailand and African's meningitis belt. Refugees and migrants are at increased risk of IMD compared with the overall population due to sero-epidemiology in their country of origin, specific characteristics of the IMD, and a number of contacts during the journey. Recently, IMD cases due to serogroups X and W have been reported and are an emerging health threat for persons arriving from Africa to refugee camps in Italy. There have been sporadic case reports of IMD due to serogroup B in Turkey; however, there has not yet been increased disease activity in this population and no outbreaks have been observed. Outbreaks of IMD in refugee camps have been and could be successfully controlled through the implementation of timely and high-coverage vaccination campaigns, and individual cases of IMD can be treated with antibiotics. Research is needed to determine the prevalence of meningococcal carriage and serogroup distribution among refugees and migrants to inform vaccine recommendations. There is no official recommendation for meningococcal vaccination of refugees. Further strategies for prevention and treatment of human immunodeficiency virus, tuberculosis and antibiotic resistance among refugees are directly related to potential prevention methods for IMD. Meningococcal vaccines have been administered only to risk groups in most host countries Thus, further strategies for the definition of new/emerging risk factors for IMD would be helpful to guide vaccine implementation for refugees and immigrants.

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Pneumococcal conjugate vaccine use during humanitarian crises

Cited by 16 publications

References 57 publications

Social contacts and other risk factors for respiratory infections among internally displaced people in Somaliland

Social contacts and other risk factors for respiratory infections among internally displaced people in Somaliland

Immunogenicity and impact on nasopharyngeal carriage of a single dose of PCV10 given to vietnamese children at 18 months of age

Meningococcal infections among refugees and immigrants: silent threats of past, present and future

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