The Pneumoccocal Vaccine in Myanmar

Living Well in Myanmar

Ensuring your child has received the pneumoccocal vaccine

HAVING worked as a primary-care physician in international clinics in Yangon over the past four years, I am familiar with the uncertainty families face about whether they have completed the appropriate courses of childhood vaccines.

People from Myanmar and all over the world come to the doctor’s office with randomly organised sheets of paper, small cardboard files and vague recollections of the various jabs their kids have received over the years. My job is then sorting out what kind of vaccination schedule they are trying to follow, what’s been given and what is missing.

Interestingly, different countries have different immunisation programs, prioritising or sometimes not including certain vaccines while administering them at a wide variety of ages. Luckily I find that children typically have received at least three-quarters of the basic vaccines regardless of where they’ve grown up, including Myanmar. The challenge is working with parents to decide how and when to fill in the extra pieces.

One of the most commonly missed vaccines for families from Myanmar or other low/middle-income countries is pneumococcal, also known as PCV-10 or PCV-13 and sold under trade names such as Prevnar or Synflorix. Although it is standard in Europe and North America, it is slowly making its way onto developing countries’ mandatory schedules. Most doctors agree that this is one of the fundamental ways to protect kids from illness.

Pneumonia – an infection in the lungs – is one of the leading killers of children worldwide, not to mention the far greater number of kids who get sick and recover. Although pneumonia is caused by a variety of bacteria and viruses, the pneumococcus, or Streptococcal pneumoniae, bacteria is one of the main agents of infection. It also creates other problems for kids by causing infections of the blood, ears, brain and sinuses. Getting vaccinated helps prevent these illnesses.

I welcomed the recent announcement that the Myanmar Ministry of Health, with the support of the international funding agency GAVI Alliance, will be introducing pneumococcal vaccination this year. The immunisation will be added to routine vaccine programs that occur every April.

If your child has grown up in Myanmar or in a country where pneumococcal is not on the basic schedule, they are likely not appropriately vaccinated. However, the good news is that it is possible to follow a catch-up schedule. Based on the Centers for Disease Control guidelines from the United States, a child older than one year will need two doses of the vaccine, while a child older than two will need one dose.

It will be interesting to follow how childhood illness patterns change in Myanmar over the coming years. Immunisation programs that are improved in breadth and scope of access can hopefully be combined with nutrition and lifestyle interventions both at the point-of-care and as national public-health campaigns. The idea is to create a knowledgeable and engaged parent who views a happy childhood in terms of preventative medicine, healthy diet and exercise, rather than merely snacks and doting.

Please speak with your doctor or township health representative about vaccination options for your newborn or growing child. Hopefully you will be patient while your doctor sorts through your child’s record and attempts to determine which country schedule you’d like to follow, how up-to-date your kid is, and what additional vaccines might have been missed because your child grew up in Myanmar or is now living in Myanmar and needs something additional.

gelsdorfMD@gmail.com  © Christoph Gelsdorf 2013