Pneumococcal disease can affect individuals of all backgrounds, but specific factors increase risk, ET HealthWorld

Mumbai: Professor Charles Fieldman, Professor of Pulmonology and Chief Physician, University of Witwatersrand, Johannesburg, South Africa, interacts with ETHealthworld’s Prabhat Prakash to discuss the difficulties in diagnosing pneumococcal disease in adults, the importance of early immunization in adults and its role in Advantages in prevention and treatment. Improve public health and reduce health care costs. Edited excerpt. What are the major difficulties in diagnosing pneumococcal disease in adults? How do these difficulties affect the health care system?

When diagnosing pneumococcal disease in adults, I encounter several significant challenges that have a profound impact on our health care system.

First, one of the major difficulties in diagnosing pneumococcal disease in adults lies in inconsistent and inadequate patient sample collection. In many cases, it may not be possible to collect a sample at all, and even if a sample is collected, the collection process may not be optimal. This results in only a few isolated samples containing the pathogen, making a definite diagnosis difficult.

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Furthermore, laboratory infrastructure for the diagnosis of pneumococcal disease is often underdeveloped, further complicating the testing process. Limitations in laboratory methods and infrastructure can lead to the risk of obtaining false negative results even when samples are collected, hampering accurate diagnosis and treatment.

Diagnostic challenges of pneumococcal disease in adults have a significant impact on our healthcare system, resulting in increased hospitalizations, strained resources, and compromised patient outcomes. Streptococcus pneumoniae is a common cause of community-acquired pneumonia and causes a heavy medical burden. Although preventable through vaccination, limited vaccine coverage and high case fatality rates pose risks to healthcare professionals. Addressing these challenges is critical to reducing the burden on our health care system.

Why is early immunization important for adults, especially those over 50 and those with chronic diseases such as diabetes and cardiovascular disease?

I emphasize that early immunization is critical for adults, especially those over 50 years of age and those with chronic diseases such as diabetes and cardiovascular disease. Pneumococcal disease can affect individuals of all backgrounds, but specific factors increase risk. These factors include age, having certain medical conditions such as chronic lung disease, chronic kidney disease and diabetes, and exposure to lifestyle and occupational hazards. Of note, adults age 50 and older are at higher risk for pneumococcal disease due to several key factors, including the natural decline in immunity associated with aging, the presence of chronic disease, and the inadequacy of childhood vaccinations to provide long-term protection protection, and the dynamic nature of disease epidemiology as specific diseases such as tuberculosis and malaria emerge and re-emerge. From a medical perspective, this emphasizes the critical role of early immunity in protecting the health of individuals in these vulnerable groups.

Please give an example of a specific vaccine-preventable infection that, if left untreated, may worsen the underlying disease in a high-risk population.

I want to highlight that some vaccine-preventable infections, if left untreated, may worsen existing health conditions in high-risk groups. These infections include pneumococcal disease, influenza, Haemophilus influenzae type B, hepatitis A, hepatitis B, tetanus, diphtheria, pertussis, human papillomavirus (HPV2, HPV4, HPV9), measles, mumps, rubella ( MMR), chickenpox (varicella, VAR), and meningococci. Emphasizing the importance of vaccination is crucial, especially for those with underlying health conditions, as untreated infections can severely worsen their condition.

How can healthcare professionals convince at-risk groups of the value of early vaccination?

Encouraging high-risk groups to understand the value of early vaccination is critical. First, health care professionals will assess the vaccination status of these people, taking into account factors such as age and specific health conditions. To be persuasive, the key is to consistently recommend vaccination at every appropriate opportunity and to use a “4R” approach (recommend, repeat, remind, review) to educate people about the importance of vaccination.

In healthcare settings, we need to ensure that vaccination is easy to access, whether that means providing the vaccine on-site or referring patients to a specialist. Keeping accurate records of vaccine administration and then sharing them with immunization registries is critical to tracking and ensuring compliance. This comprehensive approach can help at-risk populations understand the value of early vaccination, ultimately leading to better health outcomes and disease prevention.

What role should governments, medical professionals, drug manufacturers and community organizations play in creating this ecosystem?

Every stakeholder has a vital role to play in building a strong adult immune ecosystem. It is the responsibility of the government to mainstream vaccination for all age groups through primary healthcare facilities and health centres, ensuring accessibility and affordability. Healthcare professionals play an important role in educating patients and caregivers about the importance, recommendations, and administration of adult vaccinations. Drug manufacturers, especially in developing countries, have an important responsibility to deliver innovative vaccines globally with an emphasis on affordability. Community organizations contribute by raising community awareness, hosting immunization programs, and bridging the gap between health care providers and local communities. Collaboration among these stakeholders is key to overcoming challenges such as cost and limited vaccination centers. Through collective efforts, adult vaccination centers can be established, thereby increasing vaccine coverage and enhancing public health and well-being.

How are potential barriers such as vaccine access, price, and awareness considered when creating a thorough adult immunization infrastructure?

In building a strong adult immunization infrastructure, critical factors such as vaccine access, pricing, and awareness must be addressed. We can achieve this by: ensuring broad access through mobile vaccination units and home care nurses, making vaccines affordable through government programs, educating healthcare professionals and the public, integrating reminder and record-keeping technology, and implementing a vaccine coverage and effectiveness monitoring system. By considering these factors, we create a comprehensive infrastructure that can effectively overcome challenges, ultimately promoting public health and preventing vaccine-preventable diseases.

If we succeed in creating a robust adult immune ecosystem, what are the potential long-term advantages to improving public health and reducing health care costs?

As someone with deep roots in this field, I cannot emphasize enough how a strong adult immune system, especially in those 50 and older, can be a game-changer on multiple fronts. This isn’t just about shooting; it’s about health, economics and social progress.

Health Benefits: Vaccination is not only preventive; This is a lifesaver. It reduces the risk of infectious diseases like influenza and pneumonia, has the potential to eradicate certain diseases and prevent cancer. Fewer infections means fewer complications and provides a safety net for those who cannot be vaccinated for medical reasons. It also helps fight antibiotic resistance.

Economic benefits: Saving money is a bonus. Vaccinating older adults can significantly reduce costs by reducing hospital stays and treatment costs. This is a smart strategy to prevent outbreaks, stimulate vaccine development, and mitigate the financial and emotional impact on families. A healthier, vaccinated population over 50 is more productive, benefiting the workforce and the economy.

Social benefits: It’s not just about health; It’s about equity and empowerment. Widespread vaccination ensures access to health care regardless of age. It empowers women, strengthens healthcare systems, increases life expectancy and opens the door to healthier, longer lives.

Please share any best practices or suggestions for stakeholders interested in assisting the adult vaccination program in India.

Advancing India’s adult vaccination program involves several key strategies and best practices. Industry-academia collaboration has shown great promise, as evidenced by the fact that many pharmaceutical companies have established Centers of Excellence (CoEs) specializing in immunization in collaboration with renowned hospitals and medical institutions. These collaborations establish CoEs dedicated to adult vaccination, creating comprehensive ecosystems to promote adult vaccination adoption and protect individuals from vaccine-preventable diseases (VPDs). Prioritizing vaccination of high-risk groups, empowering healthcare professionals through specialized training, conducting awareness campaigns, working with government health authorities and engaging local communities are industry-driven best practices. By promoting such collaborations and employing these strategies, stakeholders can make significant contributions to the success of adult vaccination programs, ultimately enhancing public health and overall well-being.

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