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May 8, 2002


 



Emory Vaccine Study in South Africa Achieves Significant Reductions in Pneumonia

Pneumococcal Vaccine Could Prevent Leading Worldwide Cause of Childhood Death



In a recent clinical trial conducted in 40,000 children in Soweto, South Africa, scientists from Emory University and the University of Witwatersrand found that a new version of a pneumococcal vaccine reduced the incidence of pneumonia in vaccinated children by more than 20%. In addition, the vaccine reduced the incidence of invasive pneumococcal diseasepneumococcal bacteria that can be measured in the bloodstream — by more than 80% in these children not infected with the HIV virus and by more than 50% in HIV-infected children.



The study was conducted under the auspices of the World Health Organization (WHO) and the Medical Research Council of South Africa in collaboration with Wyeth Pharmaceuticals, which developed the vaccine. Keith P. Klugman, M.D., professor of international health in Emory's Rollins School of Public Health and professor of medicine in Emory School of Medicine, was principal investigator of the study. He presents the results at the 3rd International Symposium on Pneumococci and Pneumococcal Diseases in Anchorage, Alaska.

According to the WHO, pneumonia is the leading cause of death in children worldwide and is responsible for approximately four million deaths a year. Most of these deaths occur in developing countries. Although pneumonia has many different causes, the pneumococcus bacterium is the primary cause. Until recently, no vaccine was available to prevent pneumococcal disease in young children. In addition to pneumonia, pneumococcus can cause meningitis, ear infections and sinusitis.

"With this reduction in the incidence of pneumonia, we could potentially save over 500,000 lives each year in the developing world," said Dr. Klugman. "In addition, no vaccine has previously been documented to prevent pneumococcal disease in HIV-infected children, and our study showed a 50% reduction in this group. In an era in which there is little to offer to children with HIV, we can clearly reduce invasive disease."

A vaccine to prevent pneumoccocal disease, also developed by Wyeth Pharmaceuticals, is now indicated for all U.S. children to prevent invasive pneumococcal disease and bacterial meningitis, and is administered in infancy. The vaccine targets 7 strains of pneumococcal disease, but its impact on pneumonia in developing countries was heretofore unknown. The vaccine used in South Africa includes two additional strains of pneumococcus that are prevalent in developing countries.

The clinical trial randomized two groups of infants to receive either three doses of vaccine or placebo. The scientists tracked the vaccine's effectiveness over a four-year period through active surveillance of children with pneumococcal disease at the large academic hospital serving the community of Soweto, South Africa.

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