From August 21 to 22, 2024, Pfizer (Vietnam) Limited Company and the Vietnam Association of Preventive Medicine joined forces to host a series of scientific symposia titled “ASSESSING THE IMPACT OF PNEUMOCOCCAL DISEASES IN ADULTS AND EVALUATING THE EFFECTIVENESS OF CONJUGATE PNEUMOCOCCAL VACCINES” aimed at sharing updated knowledge with healthcare professionals in Vietnam.

The symposia were honored to welcome two world-renowned experts in infectious diseases and public health: Dr. Eva Polverino, Head of the Research Unit in Respiratory Infections at the Department of Respiratory Diseases, Hospital Vall d’Hebron, Barcelona (Spain), and Associate Professor Do Van Dung, former Dean of the Faculty of Public Health at the University of Medicine and Pharmacy at HCMC. Additionally, the conference series attracted over 1,000 doctors and numerous leading experts in the fields of prevention and respiratory medicine from across the country, including:
1. Associate Professor, Dr. Tran Van Ngoc – President of Ho Chi Minh City Respiratory Society
2. Professor Phan Trong Lan – Chairman of Vietnam Association of Preventive Medicine

The conference reports focused on the burden of pneumococcal disease in adults and the epidemiology of pneumococcal strains globally and in Vietnam. They highlighted the dangers of pneumococcal diseases, particularly for the elderly and those with chronic conditions. Additionally, the reports discussed the challenges in treating pneumococcal diseases due to rising antibiotic resistance, which leads to increased treatment costs and duration. Consequently, the importance of vaccination and the role of the pneumococcal conjugate vaccine for both patients and the broader community were emphasized.

The hidden risks of pneumococcal diseases in seniors
Streptococcus pneumoniae is a prevalent cause of community-acquired pneumonia (CAP), meningitis, sepsis, osteomyelitis, septic arthritis, and bacteremia worldwide (1) (2). Older adults, children, and immunocompromised individuals are particularly susceptible to pneumococcal disease. Furthermore, older adults with chronic conditions such as diabetes, chronic obstructive pulmonary disease (COPD), and chronic heart disease face an increased risk of pneumococcal disease (3) (4).
Not only does pneumococcus cause high infection rates, but it also leads to fatalities from related diseases, particularly in children and older adults (5).

Dr. Eva Polverino, Head of the Research Unit in Respiratory Infections at the Department of Respiratory Diseases, Hospital Vall d’Hebron in Barcelona, Spain, delivers a series of scientific symposia

Dr. Eva Polverino, Head of the Research Unit in Respiratory Infections at the Department of Respiratory Diseases, Hospital Vall d’Hebron in Barcelona, Spain, stated: “According to the Global Burden of Disease Study, there were approximately 344 million cases of lower respiratory tract infections and 2.18 million deaths worldwide in 2021 (6). Pneumococcus was responsible for the highest rate of these infections and deaths, with an estimated 97.9 million infections and 505,000 deaths (7). In Vietnam alone, the mortality rate due to pneumonia in 2021 was 18.2 per 100,000 people (8) (9).”

“Although significant progress has been made in reducing mortality from lower respiratory tract infections (LRTIs) and pneumococcal infections, the burden remains high (6). The risk of invasive pneumococcal disease (IPD) in adults increases with age and the presence of comorbidities (10), (11). Multiple chronic diseases may further elevate this risk (12)”, added Dr. Eva Polverino. She further explained the importance of vaccination and the role of conjugate vaccines in helping prevent pneumococcal invasive diseases.

According to the World Health Organization (WHO), an estimated 1.6 million people die each year from pneumococcal disease (13), including 600,000 to 800,000 adults, primarily due to pneumonia, meningitis, and sepsis (14). Over 90% of these deaths occur in developing countries (15). Even in developed countries, however, invasive pneumococcal disease has a high mortality rate, averaging 10-20% in adults with pneumococcal pneumonia, and this rate is significantly higher in individuals with risk factors for the disease (16) (17).

Associate Professor Do Van Dung from the University of Medicine and Pharmacy at Ho Chi Minh City delivers a series of scientific symposia

Associate Professor Do Van Dung from the University of Medicine and Pharmacy at Ho Chi Minh City added: “Risk factors that increase the likelihood of pneumococcal disease in adults include age, particularly for those over 65 years old, and weakened immune conditions such as HIV, hematological cancers, chronic kidney failure, or the use of immunosuppressive drugs. Chronic diseases like cardiovascular disease, chronic lung disease, diabetes, and chronic liver disease also elevate the risk. Lifestyle behaviors such as smoking and alcoholism further increase the risk, as smoking weakens the immune system and heightens the risk of respiratory infections, while alcoholism can impair liver function and the immune system.”

Enormous burden of pneumococcal disease
Many studies have shown that morbidity and mortality rates increase significantly with the age and immune status of the patient. For example, patients with chronic cardiovascular disease are 3-7 times more likely to develop invasive pneumococcal disease (IPD) than healthy individuals; diabetic patients are 2-5 times more likely; those with chronic lung disease are 5-17 times more likely; and cancer patients are 23-38 times more likely to develop IPD (18). This indicates that underlying diseases can elevate the risk of pneumococcal pneumonia, and conversely, pneumococcal pneumonia can exacerbate existing underlying conditions (19).

The incidence of community-acquired pneumonia (CAP) increases with the age and immune status of the patient. The mortality rate for invasive pneumococcal pneumonia varies between 6% and 20% (20).

Antibiotic resistance of pneumococcal bacteria is a major global problem (21). Resistance rates to macrolides and penicillin are rising, leading to treatment failures and increased healthcare costs (22). Some studies have shown higher mortality rates in patients with penicillin-resistant pneumococcal infections (22).

The financial burden of hospitalization and treatment for pneumococcal diseases is substantial. For instance, Europe spends over 10 billion euros annually on pneumonia treatment (22), with Germany spending about US$ 1,333 per hospitalized case of community-acquired pneumonia (22). A study in the United States estimated that in 2004, pneumococcal disease caused 4 million illness episodes, 22,000 deaths, 445,000 hospitalizations, 774,000 emergency department visits, 5 million outpatient visits, and 4.1 million outpatient antibiotic prescriptions (23). Moreover, the annual economic burden of pneumococcal disease in adults over 50 years old was approximately US$ 3.7 billion in direct treatment costs and US$ 1.8 billion in indirect costs (22). Pneumonia accounted for 22% of cases but 72% of costs. Notably, patients aged 65 and older incurred the majority of costs (US$ 1.8 billion annually) (23).

According to statistics, in Vietnam, the average cost of treatment for each patient with community-acquired pneumonia ranges from VND 15-23 million (equivalent to US$ 600-1,000), with an average hospital stay of 6-13 days (24). Therefore, timely prevention plays a crucial role in minimizing the risk of disease and the harmful effects of pneumococcal disease.

Proactive measures against pneumococcal diseases
In Vietnam and globally, population aging and the rise in chronic diseases will lead to higher rates of pneumococcal infection and increased treatment costs. Therefore, active preventing pneumococcal infection with vaccines can be considered an effective strategy to reduce the burden of disease, combat antibiotic resistance, and lower medical expenses on a macro level.

Associate Professor Do Van Dung from the University of Medicine and Pharmacy at Ho Chi Minh City emphasized: “In addition to non-specific preventive measures such as wearing masks, avoiding crowded places, and limiting transmission routes, active prevention with vaccines is one of the most important solutions.” He further explained the role of conjugate vaccines in helping prevent invasive pneumococcal diseases.
 

Darrell Oh, General Director of Pfizer Vietnam Co., Ltd., speaks the event  
 

Darrell Oh, General Director of Pfizer Vietnam Co., Ltd., stated: “At Pfizer, we have been partnering with Vietnam for many years to help address challenges in disease prevention and treatment. We believe that fostering cooperation between relevant public and private parties will enhance the healthcare system’s ability to tackle medical challenges such as pneumococcal diseases. We are proud of Pfizer’s mission to bring ‘Breakthroughs that change patients’ lives,’ including the world’s first pneumococcal vaccine and the Covid-19 vaccine. Pfizer will continue to operate under the principle ‘Science will win.’ This series of scientific conferences on pneumococcus, featuring leading experts and international speakers, clearly demonstrates Pfizer’s commitment to supporting the advancement of scientific knowledge and medical progress for healthcare professionals. We are dedicated to contributing to the protection and care of public health, creating a healthier Vietnam.”

References: