The MRC: Respiratory and Meningeal Pathogens Research Unit (RMPRU)/ NRF/DST SARCHI Vaccine Preventable Diseases Units are at the forefront of epidemiology, translational and laboratory research in the  prevention of major infectious diseases causing death in young children; i.e. pneumonia, diarrheal disease and neonatal sepsis. Also, the Unit has expanded their activities to research on vaccines in HIV-infected adults and pregnant women, which are high-risk groups for many vaccine preventable diseases. The Unit has a staff complement of approximately 200, including laboratory scientists, epidemiologist, statisticians, medical doctors, nurses and research assistants.

Since the success of undertaking the first studies on the efficacy of pneumococcal conjugate vaccine and rotavirus vaccines in Africa, the findings from these studies have informed World Health Organization recommendations for the introduction of these vaccines into public health immunization programs. Also, these studies were instrumental in South Africa being the first African country to introduce these vaccines into its public immunization program since 2009. The field-evaluation on the effectiveness of these vaccines in reducing under-5 childhood morbidity and mortality has been investigated over the past three years by RMPRU. Findings include that rotavirus vaccination has resulted in a 40% reduction in all-cause diarrhea hospitalization, whilst pneumococcal conjugate vaccine has been effective in reducing all-cause bacterial pneumonia hospitalization by 39% and has also reduced vaccines-serotype invasive pneumococcal disease by >80% in children. An additional benefit of PCV vaccination of young infants, including in South Africa, has been reduction in pneumococcal exposure and invasive disease in unvaccinated individuals –including HIV-infected adults; due to vaccinated young children now being less likely to transmit pneumococcus in the community.

Over the past four years, following successfully competing for a $10 million dollar grant from the Bill and Melinda Gates Foundation (BMGF), the Unit has expanded its research to vaccination of pregnant women. This is aimed at not only protecting the women, but also directed at protection of their newborns and young infants by enhancing in utero acquisition of protective antibodies. The BMGF funded study provided the first evidence globally, by the Unit, from a randomized, placebo controlled trial that HIV-infected and HIV-uninfected pregnant women are protected (approximately 50% efficacy) against influenza confirmed disease by influenza vaccination during pregnancy, in addition to which there is also 42% reduction in influenza confirmed illness in their infants up to 6 months of age. The findings from this study were published in the prestigious New England Journal of Medicine. Furthermore, the Unit has undertaken pivotal clinical and immunological studies that will help inform the future licensure of Goup B streptococcus (GBS) conjugate vaccine, also targeted for pregnant women with the main purpose of protecting their young infants. This work is being further funded by a $5 million grant to the Unit from Novartis, which aims at enrolling a cohort of 35 000 mother-newborn pairs to determine the correlates for protection against invasive GBS disease in neonates. Also, the Unit undertook the first study on a GBS conjugate vaccine in pregnant women in 2012/3. The Unit is also partnering with PTAH and other industry partners on further studies in the field of maternal vaccination with Respiratory Syncytial Virus (RSV), including studies on establishing correlates for protection in the young infants.



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