New Pneumonia Vaccine Can Save Lives, But Not Alone

It's easy to assume that the drug research undertaken by big-name U.S. pharmaceuticals isn't relevant to the developing world. Occasionally, though, beyond the Lipitors and Viagras, such companies do manage to come up with something that looks like a global game-changer. For evidence of the fact, look no further than Prevar 13.

Prevnar 13 is a drug that prevents 13 virulent strains of staphylococcus infection. Put more simply, the drug -- which the FDA approved for use in U.S. populations last Wednesday -- protects in 90% of cases against pneumonia, with side effects similar to other vaccines.

Why is this important? Well, to begin with, pneumonia affects both the young and the elderly. According to the World Health Organization, it kills roughly one million children per year, and is the top vaccine-preventable killer of children under age five in the developing world. What's more, the bacteria that this vaccine targets are also responsible for many other infections, including ear infections, sepsis and meningitis.

But despite what some people would like to think, science isn't the answer to the developing world's burden of disease.

Right now, the Prevnar vaccine carries a hefty $432 price tag per full regime (4 doses). In fact, Prevnar is projected to be Pfizer’s biggest moneymaker once their top drug, Lipitor, loses its patent next year. The Global Alliance for Vaccines and Immunization (GAVI) and Pfizer plan to make Prevnar available at much-reduced prices in the developing world, but they have yet to identify what “much reduced” means.

Then there's the fact that Prevnar needs to be administered on a strict timetable four times during a child’s early development -- and requires refrigeration as well. That frequency, along with the timing of required clinic visits, presents an enormous challenge for those living far from care, or those who need time off work to get there. Ensuring that the drug stays perfectly cold -- from manufacturing to the time of its injection -- is also a notoriously hard task to accomplish.

Vaccines often seem like magic bullets, but the fact is, vaccine delivery and financing are just as important as scientific development. Take, for example, Prevnar 7 (the precursor to this newest vaccine). Prevnar 7 also looked promising, and demonstrated major preventative benefits against pneumonia. But it didn’t make much of a dent on developing-world pneumonia rates.

It's a grim fact that biomedical interventions alone -- including vaccines -- often do little to curb epidemics. For example, currently, there are vaccines available for measles, whooping cough and tetanus. Yet these conditions remain among the top causes of death for children in the world. Indeed, the only disease to have been eradicated through vaccines is smallpox, and that success required an approach that resembled a military strategy (one that many consider both brilliant and abusive of human rights).

The small-pox success also benefited from the fact that the vaccine was temperature-stable, inexpensive, single-dose and didn’t require dangerous hollow needles (it instead used a bifurcated needle). The vaccine injection also left a small scar, so that professionals could tell if someone had already been vaccinated without any paperwork. We can only pray that our newest vaccines have a likewise fortuitous combination of features.

As a society, we tend to place the onus of disease prevention on scientists in lab coats, not on the governments and agencies that are in a position to use and distribute these biomedical innovations. But if vaccines like Prevnar are going to have an impact, we need to see a lot more than just a reduction in price.

Photo Credit: I woz ere