A leading expert on infectious diseases has warned that shifting to an “inferior” PCV-10 anti-pneumonia vaccine could increase the mortality rate among Filipino children who are under threat of deadly pulmonary diseases.
In an interview, Dr. Ron Dagan, professor of pediatrics and infectious diseases at Israel’s Ben-Gurion University and former chairman of the board of the International Symposia on Pneumococcus and Pneumococcal Diseases, said that while the vaccines PCV-10 and PCV-13 are both good vaccines, PCV-13 is “clearly superior.”
“There are different additional serotypes that PCV-13 covers that PCV-10 does not cover. PCV-13 covers very well serotype 19A and 6A that are not in PCV-10, and to a certain extent serotype 3,” he said.
Serotype 19A is the most virulent and prevalent type of deadly microbe that causes pneumonia, which remains to be the top cause of death among Filipino children 5 years or younger. It is also antibiotic resistant.
Serotype 6A, on the other hand, is a cause of invasive pneumococcal disease while serotype 3 is associated with complicated pneumonia.
“Serotype 19A will not respond well to PCV-10 and will increase with PCV-10. Once you give PCV-13, it will decrease. So maybe you are thinking I can give PCV-10 at the moment, and save some money, but what that means is you will see an increase in diseases caused by 19A – you will see increased number of children with meningitis caused by 19A. You will see increased number of severe pneumonia caused by 19A. You will see increased mortality caused by 19A,” Dagan said.
“You will observe a lot of diseases that not only were not prevented by PCV-10, but also were induced by PCV-10 because PCV-10 increased the 19A prevalence in your country. But if you start from the beginning with PCV-13, you save all of those cases that could occur if you start with PCV-10,” he added.
In the Philippines, the Department of Health has been using PCV-13 since 2014, but there have been recent efforts to shift to PCV-10 – a move that has been described by former Health Secretary and now Iloilo Rep. Janette Garin as a “step backward.”
“That’s like getting a Betamax when you’re already using a VHS player,” Garin said, describing PCV-10 as a “weaker” vaccine.
Dagan said there have only been two examples of countries that switched from PCV-13 to PCV-10 as the rest have switched from PCV-10 to PCV-13.
“One example, a country which has very good surveillance, was Belgium. Belgium for many years has a lot of pneumococcal disease in children and it started with PCV-7. Diseases associated with serotype 19A started to go up in a very frightening rate, and they switched after a while to PCV-13. They saw a beautiful reduction of overall disease and 19A diseases to a point where 19A was very, very low in the community.”
“After several years, of using PCV-13 successfully, they thought that maybe now it’s time to switch to PCV-10, because they don’t see much 19A. What they found within two years after switching back to PCV-10 was that they had an amazing increase of 19A diseases, together with an increase in overall diseases to almost previous rates as before PCV-13 was introduced,” Dagan said.
Pneumonia is a leading cause of death among children, and data from the World Health Organization showed that in 2017, close to a million children aged 5 and below died of pneumonia-related diseases worldwide.
The Philippines is among the 15 countries that make up 75 percent of the world’s childhood pneumonia cases, with a mortality rate of 23.4 per 100,000 people.