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Vaccines are generally cost-effective public health tools for the prevention and control of infectious diseases [101]. Their routine use has had an enormous impact on the control of diseases such as diphtheria (D), tetanus (T), pertussis (whooping cough; using whole cell [wP] or acellular [aP] vaccines), poliomyelitis (using oral poliovirus vaccine [OPV] or inactivated poliovirus [IPV] vaccine) and Haemophilus influenzae type b (Hib) [1-5].
According to the WHO Global Immunization Vision and Strategy, challenges facing immunization programs today include vaccinating more people with existing and new vaccines, especially where health systems and infrastructure are weak, and meeting the increasing demand for immunization [102]. Disparity in access to healthcare, nevertheless, remains a major hurdle to accessing life-saving vaccines. The past decade has shown an increase in the number of vaccines currently licensed and recommended for use in infants and children. Existing immunization programs need to be strengthened by improving compliance, vaccination timelines, safety and optimizing effectiveness [101].
The development of combined vaccines has been a public health interest and a priority, and their use is recommended by the WHO. These vaccines can reduce the cost of the delivery process and increase compliance [6,7] with the potential of enhancing the delivery of vaccines to infant populations [6,8]. Those combining whole cell- Bordetella pertussis antigens with diphtheria and tetanus toxoids (DTwP vaccines) have been central to the Expanded Program of Immunization (EPI). Additionally, the inclusion of new antigens to an existing combination vaccine ensures early high coverage by maintaining established immunization schedules [9-11]. However, it is important to ensure that the safety, immunogenicity and efficacy of the combined administration of several vaccine antigens compares favorably to monovalent administration. Other benefits of combination vaccines include reduction in the number of required injections and an associated reduction in the frequency of pain experienced by children [9-12].
This article provides an overview of the worldwide clinical experience with an established DTaP-IPV//PRP∼T combination vaccine, Pentaxim(TM)(TM) (Sanofi Pasteur; marketed as Pentavac(TM)(TM) in Western Europe and as Pentaxim throughout the rest of the world; we will refer to this vaccine as Pentaxim in this article). The public health and economic benefits of including this vaccine in national childhood immunization programs are also discussed.
Burden of childhood diseases & vaccine development
Diphtheria, tetanus, pertussis...