Yii: Use PCV13 vaccine instead for better protection of children

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Dr Kelvin Yii — Photo via Facebook/Kelvin Yii Lee Wuen

KUCHING (Nov 12): Bandar Kuching MP Dr Kelvin Yii has urged the government to consider changing its pneumococcal vaccine under the National Immunisation Programme (NIP) from the PCV10 pneumococcal vaccine which protects against fewer bacterial strains to the PCV13 vaccine to give better protection for children against the more prevalent serotypes in Malaysia.

He said this in his budget debate so the government could change its procurement approach when it comes to this vaccine especially for children.

“I am concerned the government will be ‘penny-wise, pound foolish’ because our children may be deprived of a better vaccine and that it may not achieve its target of adequate protection for our children from all common serotypes.

“Pneumonia kills more children than any other infectious diseases, claiming the lives of over 800,000 children under five every year, or around 2,200 every day. In Malaysia, the incidence of invasive pneumococcal disease (IPD) is estimated at 3.8 per 100,000 cases each year,” he said in a statement yesterday.

Yii said the most common pneumococcal detected in Malaysia is serotype 6A and 19A which are not covered under PCV10.

“In settings where disease attributable to serotype 19A or 6C is significant, PCV13 will have additional benefit as it contains additional serotype 3, 6A and 19A. PCV13 provides the broadest coverage of IPD consistently in most countries in Asia.

“In Malaysia, PCV13 provided 86.1 per cent serotype coverage of IPD serotypes in children below five years old in comparison to 62.9 per cent serotype coverage for the other pneumococcal vaccine (PCV10) in Malaysia,” said the DAP lawmaker.

Based on the 2019 World Health Organsiation (WHO) position paper on Pneumococcal Conjugate Vaccination (PCV), he said the choice of product to be used in a country should be based on programmatic characteristics, vaccine supply, vaccine price, local and regional prevalence of vaccine serotypes and antimicrobial resistance patterns.

“In a cost-effectiveness analysis for Malaysia published in 2020, it was found that the introduction of PCV13 into the NIP in Malaysia for children aged up to two years is expected to not only reduce the overall disease burden but also contribute to significant savings from direct medical costs and indirect costs related to productivity loss as well as higher magnitude of net cost saving for the health system.

“The introduction of PCV13 in Malaysia NIP is estimated to reduce 4,086 of invasive pneumococcal disease (IPD) cases, 160,833 cases of acute otitis media (AOM), 25,708 of pneumonia in comparison to PCV10 over a span of five years,” he said.

The 2019 WHO Position Paper on ‘Pneumococcal Conjugate Vaccines in Infants and Children under five years of age’ states that while PCV 10 may be cheaper initially, but if evaluated over a five-year period, PCV13 was estimated to save an additional RM665 million compared to the use of PCV10, he added.

This demonstrated significant cost saving potential as well as cost effectiveness of including PCV13 instead of PCV10 into the NIP.

On top of that, Yii said PCV13 is the most widely used pneumococcal conjugate vaccine globally which is introduced in NIPs in 133 countries with exclusivity in 127 countries.

He said several countries had switched from PCV10 to PCV13 in their NIP since 2015, including Peru, Armenia, Azerbaijan, Chile, Paraguay, Mozambique, Myanmar, Albania, Slovenia, Belgium, El Salvador and Austria.

As such, he believed it is important the health minister makes the decision to change the country’s procurement strategy and procure the PCV13 instead.

“The government must also explain its initial decision to purchase PCV10 which includes greater transparency in the whole deal including the differences in cost for the purchase of PCV10 compared to PCV13, the company that was given the tender.

“This is important to make sure there is no wastage and that we can make sure that we provide the best coverage for our people,” he added.