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Pneumonia kills more than 1.3-million children a year. But with this vaccine two out of every three children under five are immunised against pneumonia. (Eduardo Munoz, Reuters)

When it comes to vaccines, there really is safety in numbers. Here's why

Keith Klugman
Turns out it takes a village to raise a child but also to protect them.

COMMENT

The famous African proverb,“It takes a village to raise a child”, is absolutely true. There is nowhere that this sense of community— of common responsibility —is stronger than in Africa.

As Africans, we draw our strength from each other.

The story of human progress is one of collectives. Realising our greatest achievements, overcoming our most challenging obstacles and telling humanity’s shared story has always relied on one common denominator: collaboration. We are at our strongest when our neighbours can rely on us just as we rely on them.

Yet, despite the collective power of our communities, some challenges are still incredibly daunting. When faced with a widespread public health issue such as pneumonia, for instance, it is easy to feel overwhelmed.

The statistics speak for themselves: according to Unicef, pneumonia is responsible for  17% of deaths in children under the age of five in sub Saharan Africa — making it the leading cause of childhood mortality.

Globally, the illness kills about 1.3-million young children each year, according to 2011 estimates published in The Lancet medical journal. It sometimes feels like one person cannot make a difference when faced with such an enormous problem. 

But there is strength in numbers. 

Especially with vaccines.

When a significant number of people in a population are vaccinated, they help to protect the unvaccinated people around them from diseases such as pneumonia. This is called  “herd protection” and it works by breaking the cycle by which pneumonia is passed from one person to another.

Because, when most of a community is vaccinated, even the odd case of pneumonia is unlikely to spread to more people. In this way, the community itself becomes a tool to fight infectious disease and especially protects those among us who are the most vulnerable to getting sick, such as newborn babies, the elderly, or those with health conditions.

Watch: You and herd protection. Our Laura Lopez Gonzalez explains

Herd protection is no substitute for getting vaccinated, and the key to unlocking the power of herd protection against pneumonia is the  pneumococcal conjugate vaccine (PCV).

In 2009, South Africa — alongside Gambia and Rwanda — became the first African nation to introduce the PCV. Fast-forward to today and data from the public-private partnership for vaccines Gavi show that  35 countries across Africa are ensuring that vulnerable populations are protected against pneumonia by the PCV, which is fantastic progress.

By the end of 2017, PCV had been introduced in 140 countries but global coverage was estimated at just 44%, World Health Organisation (WHO) and Unicef data from 2018 show.

Those numbers are good, but we can achieve better coverage if we work together. WHO estimates from 2017 show that more than two-thirds of South Africans have been vaccinated against pneumonia in the 10 years since the PCV was introduced.

Although this is cause for celebration in some respects, more than 30% of the country remains unprotected against the disease. Here is a statistic that should inspire hope.

According to a 2017 study in the International Journal of Infectious Diseases, we can achieve herd protection in South Africa if just two out of every three children under five are immunised against pneumonia.

This is an ambitious but achievable vaccine coverage rate and would help tens of thousands of South African children every year to grow up healthy and strong, fulfilling their potential.

Of course, to create continent-wide protection, we must aim for each and every child to receive the PCV. When we each do our part, not just for ourselves but for our neighbour, our village, our country and our continent, we can defeat pneumonia. Closing the immunisation gap is the final piece of the puzzle.

Because it takes a village not only to raise a child but also to protect them.

Keith Klugman is the director for pneumonia at the Bill & Melinda Gates Foundation. You can follow him on Twitter @findingpneumo. [Full disclosure: The Bill & Melinda Gates Foundation funds the Bhekisisa Centre for Health Journalism]

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