New vaccine programs to improve child health

Issue: BCMJ, vol. 45 , No. 5 , June 2003 , Pages 214 BCCDC

On 27 February 2003 the Ministry of Health Planning announced funding for two new vaccine programs: pneumococcal conjugate and meningococcal C conjugate. These vaccine programs will be introduced in three phases that prioritize the provision of vaccine to those at highest risk for pneumococcal and meningococcal disease.

Phase One
Phase One begins 1 April 2003, with provision of both:
• Pneumococcal 7-valent conjugate vaccine (Prevnar) to infants and children 2 months to 59 months of age at high risk for pneumococcal disease and to all aboriginal infants and children 2 months to 59 months of age.

• Meningococcal group C-TT conjugate vaccine (NeisVac-C), to individuals of all ages, starting at 2 months of age, who have health conditions that place them at higher risk for meningococcal disease.

Infants and children at high risk for pneumococcal disease are those with:

• Anatomic or functional asplenia (for this indication, vaccine to be provided to children up to and including 16 years of age).

• Sickle cell disease.

• Immunosuppression related to disease (e.g., HIV, lymphoma, Hodgkin’s, multiple myeloma) or therapy (e.g., high dose, systemic steroids).

• Receipt of a hematopoietic stem cell transplant (HSCT) or solid organ transplant.

• Chronic cardiorespiratory disease.

• Chronic liver disease including cirrhosis, chronic hepatitis B or C.

• Chronic renal disease.

• Diabetes.

• Chronic CSF leak.

• A cochlear implant, or those who will be receiving a cochlear implant.

It is also recommended that children ≥ 2 years of age, with any of the preceding health conditions, receive the pneumococcal polysaccharide vaccine (Pneumo 23). This is not a new recommendation. For several years, the Ministry of Health Services has been providing pneumococcal polysaccharide vaccine to all individuals ≥ 2 years of age at high risk for pneumococcal disease.

Individuals eligible for the meningococcal conjugate vaccine, include those with:

• Functional or anatomic asplenia.

• Complement, properdin, or factor D deficiencies.

• Hematopoietic stem cell transplant (HSCT).

• Solid organ transplant.

• A cochlear implant, or who will be receiving a cochlear implant.

It is also recommended that children ≥ 2 years of age with any of the preceding health conditions receive the meningococcal polysaccharide vaccine.

Phase Two
Starting 1 July 2003, meningococcal C conjugate vaccine will be provided to infants at 12 months of age. Infants at this age require only one dose of vaccine. Infants born on or after 1 July 2002 will be eligible for the vaccine. There will not be a catch-up immunization campaign.

Phase Three
Phase Three starts September 2003 with the following:

• Pneumococcal conjugate vaccine provided to infants starting at 2 months of age. Infants born on or after 1 July 2003 will be eligible for this vaccine. No catch-up immunization program is planned. Infants will be immunized at 2, 4, 6, and 18 months of age. 

• Meningococcal C conjugate vaccine will be provided to all grade 6 students. This will be a school-based immunization program, with no catch-up immunization program.

It is estimated that the pneumococcal conjugate vaccine program will annually prevent:

• 10 000 cases of middle ear infection

• 700 cases of pneumonia

• 100 cases of bacteremia and meningitis

• 550 hospitalizations

• 11 000 physician visits

• One to two deaths

The meningococcal C conjugate vaccine program is estimated to prevent 7 to 15 cases of bacterial meningitis and two deaths each year. Meningococcal infections are among the most feared by members of the public because of their dramatic and swift presentation.

These two new vaccines are expected to significantly improve child health.

—Karen Pielak, RN, MSN
Nurse Epidemiologist
Epidemiology Services
BC Centre for Disease Control

K. Pielak, RN, MSN. New vaccine programs to improve child health. BCMJ, Vol. 45, No. 5, June, 2003, Page(s) 214 - BCCDC.



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