In India, where approximately 95 per cent of deaths due to vaccine-preventable diseases occur in adults, pneumococcal disease represents a significant health burden, particularly for adults aged 50 years and above. This disease also poses serious risks for patients with comorbidities such as COPD, Asthma, Chronic Kidney Disease, Diabetes, and cardiovascular diseases. In an exclusive interaction with BW Healthcare World, renowned global expert in the field of pneumococcal disease, Prof. Julio Alberto Ramirez, M.D., F.A.C.P., Professor of Medicine and Chief of the Division of Infectious Diseases at the University of Louisville shared valuable insights into this pressing health issue.
Prof. Julio highlighted that pneumococcal disease, caused by the bacteria Streptococcus pneumoniae, presents a substantial health challenge in India. The country holds approximately 25 per cent of the global lung infection burden, and among adults over 50, one out of five cases of pneumococcal infections leads to mortality. Detection of S. pneumoniae is often challenging due to limited testing facilities and overuse of antibiotics, making vaccination crucial to safeguarding lives and public health.
According to Julio, chronic conditions such as COPD and diabetes weaken the immune system's ability to fight infections effectively. For instance, individuals aged 30-49 with COPD have an 8.9 times higher risk of pneumococcal lung infection compared to those without COPD, with the risk increasing to 9.8 times in the 50-64 age group. Similarly, individuals aged 18-49 with diabetes have a risk of pneumococcal lung infection 3.1 times higher than those without diabetes, and three times higher in the 50-64 age group. Managing these chronic conditions through medication, lifestyle modifications, and early vaccination is crucial in reducing the risk and severity of pneumococcal disease.
To enhance awareness and promote early pneumococcal vaccination, especially among individuals with comorbidities, a multi-faceted approach is essential. Prof. Ramirez emphasised that healthcare professionals should conduct risk assessments, assess immunisation status, recommend vaccines based on risk, counsel patients on the importance of vaccination, and document the administered vaccines for record-keeping. This comprehensive strategy can help build stronger conviction among healthcare professionals and the public about the need for early pneumococcal vaccination.
Numerous studies have demonstrated significant clinical benefits of pneumococcal vaccination. Prof. Ramirez noted that in India, widespread pneumococcal vaccination can substantially impact public health outcomes. Indian studies have shown that vaccination leads to decreased ICU admissions, reduced ventilator usage, shorter hospital stays, and less severe exacerbations in patients with chronic conditions such as COPD. These benefits highlight the importance of pneumococcal vaccination in preventing severe illnesses like lung infections and sepsis.
Beyond clinical benefits, widespread pneumococcal vaccination can significantly reduce hospitalisations and treatment costs, translating to direct cost savings for healthcare systems and alleviating the burden on healthcare facilities. Prof. Ramirez pointed out that private hospitals, serving as Centers of Excellence (CoE) for adult vaccination, play a pivotal role in promoting these programs, contributing to improved patient outcomes and enhanced overall public health in India.
Establishing a robust adult vaccination infrastructure in India necessitates leveraging existing healthcare channels, providing pre-surgical vaccination recommendations, implementing outreach efforts, and offering home vaccination services. Integrating vaccination education into routine consultations and utilising technology for reminders can optimise vaccine uptake. Prof. Ramirez notes the importance of systematic documentation of vaccination status and implementing best practices from other countries to further enhance the effectiveness of vaccination programs.
Recent advancements in pneumococcal vaccines hold promise for addressing emerging antibiotic resistance, according to Prof. Ramirez. Vaccination reduces the reliance on antibiotics, thereby curtailing unnecessary usage. The pneumococcal conjugate vaccine, for instance, has demonstrated efficacy in reducing antimicrobial resistance of Streptococcus pneumoniae, offering a promising avenue for improving public health outcomes and mitigating the global threat of antimicrobial resistance.
Policymakers and healthcare providers should collaborate to integrate emergency supplies into vaccination centers, harmonise guidelines, identify priority population groups, disseminate information on vaccine safety, monitor vaccine coverage and adverse events, and implement strategies for emergencies. Effective communication and collaboration can ensure that all communities have access to life-saving vaccines, ultimately contributing to improved public health outcomes, stressed Prof. Ramirez.
To effectively combat pneumococcal disease in adults, it is imperative to prioritise vaccination efforts through a comprehensive approach. Julio remarked that healthcare professionals and policymakers should work together to ensure that tailored messages are shared with patients. These messages should emphasise the relevance of pneumococcal vaccination based on individual factors such as age, health status, lifestyle, and occupation. Addressing patient concerns in clear language and reinforcing the protective benefits of vaccination are crucial. Harmonised vaccine recommendations across different age groups and establishing adult vaccination centers can significantly reduce the burden of pneumococcal disease in the adult population.
As India continues to address the significant health burden posed by pneumococcal disease, the insights shared by Prof. Julio Alberto Ramirez underscore the importance of vaccination, especially among adults aged 50 and above and those with chronic conditions. By enhancing awareness, establishing a robust vaccination infrastructure, and fostering collaboration between policymakers and healthcare providers, India can make significant strides in combating this preventable disease and improving public health outcomes.
