KARACHI, Sept 2: The much-awaited pneumococcal conjugate vaccine (PCV) is likely to be included in the routine immunisation programme for free administration to children in their first year of life across Sindh in November, it emerged on Sunday.

Sources privy to immunisation activities said the launch of the pneumococcal vaccine was planned for January 2011 with major financial support of the Global Alliance for Vaccines and Immunisation (Gavi). However, apparently the devolution of health-related activities and offices and some technical requirements delayed the introduction of the vaccine in the public sector health-care delivery system.

They added that the authorities concerned and the provincial expanded programme on immunisation had geared up for the launch of the vaccine as part of free immunisation service for children.

Meanwhile, a training workshop for government doctors began in Karachi under the supervision of the WHO’s technical officer Qamarul Hasan on Thursday. Doctors being trained as master trainers would groom hundreds of government employed field-staffers or vaccinators and lady health workers in batches across the province in vaccinating the intramuscular PCV.

Master trainers have been trained in Punjab, where the PCV is likely to be included in its routine vaccination programme next month. Sindh would be the second province to launch the vaccine, said an official attending the training workshop.

A couple of experts in paediatric diseases, including the then chairman of the Pakistan National Immunisation Technical Advisory Group, had announced in 2009 that Pakistan would include the pneumococcal vaccine in its Expanded Programme on Immunisation (EPI) by Jan 1, 2011 as it had successfully established its case for funding with Gavi, has been helping Pakistan in the area of immunisation and health development since 2001.

Pneumococcal disease is the leading cause of pneumonia, the biggest infectious killer of children under five in Pakistan and around the world. Globally, pneumonia is responsible for 4,300 child deaths daily, or one in every 20 seconds, while in 2007, the World Health Organisation had recommended the introduction of pneumococcal vaccine into all national immunisation programmes, particularly in countries with high child-mortality rates, said a child specialist.

Prof Dr Iqbal Memon, president-elect of the Pakistan Paediatric Association, said that about 40 million pneumonia episodes in children up to five years were recorded while over 100,000 children died due to the disease every year in the country.

With a PCV coverage rate of over 85 per cent, we can save about 27,000 to 30,000 children from dying of pneumonia in Sindh alone, he said and added that the pneumococcal conjugate vaccine is only available in the private market at present and as per estimates the vaccine is being given to only 1.6pc to 2pc of the cohort children in their first year.

The pneumococcus germ may cause meningitis, pneumonia, blood stream infections in children and as such there was a dire need to protect children from the most serious pneumococcal infections which happen during the first two years of life, he said and added that the inclusion of the PCV in routine immunisation would certainly prove a good intervention, reducing the overall child mortality rate in the province and the country.

A marketer said there were two types of PCV in the local markets, covering 10 strains and 13 strains of the pneumococcus, respectively, with prices ranging from Rs4,200 to Rs5,300 per single dose vial.

At present the national EPI targets prevention of eight EPI diseases by vaccination: childhood tuberculosis, poliomyelitis, diphtheria, pertussis, tetanus, hepatitis, haemophilus influenza type b and measles.

Provincial EPI director Dr Mazhar Khamesani said the new service (PCV) would be provided to about 1.37 million children aged up to one year.

The prerequisites of the PCV launch included training of our field staffers and specific cold rooms for the storage of the new vaccines, he said and added that the training component was being taken care of by the World Health Organisation while the United Nations Children's Fund had been entrusted with the job of installing cold rooms, already available with the financing of Gavi.

Sindh had 11 standard cold rooms at Karachi, Hyderbad, Sukkur and Larkana, while Kashmore, Badin, Dadu, Sanghar, Khairpur, Benazirabad, Naushehroferoz and Tharparkar would get one room each, Dr Khamesani said and pointed out that the installation process had already begun.

Replying to a question, he said PCVs would be received from Gavi soon and all efforts, including the training of relevant staffers at district level, were on to ensure the launch of the vaccine in November.

He further said that the three doses of the new vaccine would be given in the first year — at six weeks, 10 weeks and 14 weeks of age. At present children are brought to the vaccination centres at six, 10 and 14 weeks of age to get one dose each of OPV and Pentavalent vaccine during each of these visits, he said.