Both RSV and Dengue have proved to be difficult vaccine targets. In both cases vaccine development has taken a very long time, and in both cases some vaccine candidates have led to more severe disease in some individuals. We are currently in the middle of an era of remarkable progress in both fields, but problems remain.
The Bacille Calmette-Guérin (BCG) vaccine, a 100-year-old vaccine usually given to protect against tuberculosis, also has ‘off-target’ effects on the immune system that protect against other infections and allergic diseases.
“Vaccine inequity – The world is on the brink of a catastrophic moral failure, and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries.”
Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
The availability of effective vaccines for the prevention of covid-19 has led to an unseemly competition as countries rushed to sign deals with manufacturers, often outbidding each other for access, to the exclusion of poorer countries. In high income countries 60% of people have received at least one dose of Covid vaccine, while in low income countries the figure is 3%.
We have a National Roadmap, which includes COVID-19 vaccine coverage targets for the easing of restrictions. But how do children and adolescents fit into this, with regard the direct and indirect effects of Delta on their health and well-being?
Tuberculosis is a major cause of child morbidity and mortality globally. Young children are at particular risk of severe and disseminated disease following exposure to a person with tuberculosis. Public health and clinical services, including in Victoria, focus on early detection and treatment of both disease and infection. There have been recent developments that potentially strengthen and decentralise services for tuberculosis.
Never in the field of health was so much learned by so many in so few months. This, the opening Grand Round for 2021 will recap the lessons from last year, take stock of where we are in February 2021, describe the complex situation with vaccines, and look to what the year might hold for the pandemic and children in Australia and countries around the world. Topics will include: Why is COVID-19 less severe in children? What is the role of schools in transmission and what is the impact of new variants? Vaccines: who, when and how? The indirect effects of Covid: poverty and malnutrition, measles, loss of education, and child marriage.
It is World Pneumonia Day on November 12th. Pneumonia and other acute lower respiratory infections remain the most common causes of childhood death, and illness requiring hospitalization globally. This is despite the effective pneumococcal conjugate vaccine (PCV) being widely available, which points to the varied causation of childhood pneumonia in 2020.
In the early decades of European settlement, Australia was free of some infectious diseases such as measles, scarlet fever and diphtheria which could not survive the long voyage to Australia. When these infections did arrive, as shipping times reduced, resistance was low and severe epidemics occurred, especially among children in the crowded slums of the cities, and among indigenous populations who were previously free of these infections.
The effect of epidemics on pregnant women and newborns has often been neglected, so what do we know about the effects of COVID-19 in pregnancy and newborns?
As vaccines and other treatments are developed, should pregnant women also be included in clinical trials?
In low- and middle-income countries, disruption of essential maternity and newborn services may erode many of the gains made in maternal and child health over the past two decades.
The exit strategy for COVID-19 is a vaccine. To stop this pandemic we may need to vaccinate a significant proportion of the entire global population of 7 billion people. Where are we up to with vaccine development? Who gets vaccinated? How to communicate the benefits of a novel, fast tracked vaccine when misinformation is already spreading.
