New study queries pneumonia jab as state adamant

A study at Gertrude’s Children’s Hospital, Nairobi, has shown that the pneumonia vaccine is not effective.

But the Health ministry, donors and industry players have strongly defended the vaccine, saying it is effective.

“Kenyan children receiving PCV-10 pneumonia vaccine are not protected,” says the study.

The explosive report by researchers from the hospital, the Aga Khan University Hospital in Nairobi, Kenyatta University and the University of Embu says the vaccine does not protect children against local strains of the top killer disease.

“This is a very important finding as it explains the high level of child illness and deaths from pneumonia despite the availability of PCV-10,” says the study few are willing to comment on.

The pneumonia vaccine, highly subsidised through GAVI – Vaccine Alliance, was launched in Kenya in 2011 by former President Kibaki following high death rates from the disease.

In 2010, the Kenya Economic Survey reported pneumonia to have caused 19,508 deaths which continued to rise overtaking malaria as the top killer in 2015.

Consecutive Economic Survey reports have shown the disease to have killed 19,011 in 2013, 20,000 in 2016 and 21,584 last year making pneumonia the top killer ahead of malaria and cancer.

The GAVI Alliance sponsorship, however, ends in 2022 meaning Kenya will have to decide whether to continue with the expensive vaccine without donor support.

Financial dealing

Under the current arrangement with GAVI, Kenya contributes Sh72 million annually towards cost of the vaccine.

However, estimates indicate that without donor support Kenya would have to pay about Sh1.5 billion more annually for the pneumonia vaccine.

Coincidentally, two reports archived last month by the Ministry of Health show that donors and vaccine manufacturers say the vaccine has been wildly effective and should be continued even after the donor pullout.

Institutions involved in the latter studies included the Ministry of Health, KEMRI-Wellcome Trust Research Programme, London School of Hygiene and Tropical Medicine, UNICEF, University of Oxford, UK, Johns Hopkins Bloomberg School of Public Health, US, Pfizer Vaccines, France, GAVI and Bill and Melinda Gates Foundation.

Main investigator Laura L Hammitt declares having had financial dealing with vaccine manufacturers: Novavax, GlaxoSmithKline Biologicals, Merck, and Pfizer Inc.

Two studies archived last month with bioRxiv show that the pneumonia vaccine has been highly effective and its use should continue.

The reports say for example in Kilifi, pneumonia has reduced by 68 per cent in children under-five years since the vaccine was introduced.

“These findings suggest that routine infant PCV-10 immunization programmes will provide substantial direct and indirect protection in low-income settings in tropical Africa,” says the reports.

Owing to this success, the reports strongly recommend that Kenya continue funding the vaccine even after the planned donor pull out in 2022.

The problem, the reports acknowledge, it will be quite expensive. In 2015 for example Kenya health budget was $600 million (Sh60 billion) with $6.9 million (Sh690 million) going to buy various childhood vaccines.

Inconsistencies

“We have estimated that continuing with PCV after 2022 will require an additional $15.6 million (Sh1.56 billion) annually compared to discontinuing PCV; in other words, it will more than double Kenya current expenditure on vaccines.”

Last year the Strategic Advisory Group of Experts (SAGE) of the World Health Organisation released an evaluation of the pneumonia vaccine.

It concluded that while research data showed the vaccine to be effective, paradoxically the disease remained high especially in poor countries.

“This would be enough reason to look into the Gertrude’s hospital study. But that won’t happen, not with the clout behind the vaccine supporting group,” said a senior official at the Health Ministry who requested anonymity.

The Gertrude’s report was posted in June by the open peer review journal F1000Research but has yet to receive any reviews.

“We can’t comment or give much weight to the yet to be reviewed study which already shows inconsistencies,” said Iryna Mazur of GAVI in answer to our inquiries.

“I think it would be unethical for us to discuss the paper while still under review,” said lead investigator Michael Walekhwa of Gertrude’s Hospital.

UNICEF and the Department of Immunization at the Health ministry did not respond to our inquiries.

“There may not be enough brave researchers in vaccines to oppose the position taken by the big boys. You can take that to the bank,” said our source at the ministry.