Pneumococcal vaccine significantly reduces disease in South African children

ATLANTA--In a clinical trial conducted in nearly 40,000 young children in Soweto, South Africa, a pneumococcal conjugate vaccine aimed at nine strains of disease reduced the incidence of pneumonia in fully vaccinated children by 25 percent. In addition, the vaccine reduced the incidence of invasive pneumococcal disease (pneumococcal bacteria in the bloodstream) by more than 83 percent in non-HIV-infected children and by more than 65 percent in HIV-infected children. The vaccine also significantly reduced the incidence of invasive pneumococcal disease caused by antibiotic-resistant strains by between 56 and 67 percent, depending on the type of resistance.

The study took place between 1998 and 2000, with follow-up through 2001. The results are published in the October 2 issue of The New England Journal of Medicine.

Participating institutions included Emory University, the University of the Witwatersrand in South Africa, Johns Hopkins University and Wyeth Pharmaceuticals, under the auspices of the World Health Organization (WHO) and the Medical Research Council of South Africa. Keith P. Klugman, MD, professor of international health in Emory University's Rollins School of Public Health and professor of medicine in Emory University School of Medicine, was principal investigator of the study.

The clinical trial randomized two groups of infants to receive either three doses of the conjugate vaccine or placebo. In addition, all children received Haemophilus influenzae type b (Hib) conjugate vaccine. The scientists tracked the conjugate 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. Antibiotic-resistant strains of pneumococci are common in Soweto, and HIV infection is the leading risk factor for invasive pneumococcal disease. The overall mortality rate in the clinical trial was reduced by five percent among all children a

Contact: Holly Korschun
Emory University Health Sciences Center

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