Pneumonia still a leading threat to children in SA despite vaccines

Pneumonia remains top threat to SA children despite vaccines. Picture: Cottonbro studio/Pexels

Pneumonia remains top threat to SA children despite vaccines. Picture: Cottonbro studio/Pexels

Published May 22, 2024


Pneumonia is a major cause of hospitalisation and death among children and adults in South Africa. HIV-infected individuals, regardless of age, are particularly at risk of severe illness and death from pneumonia.

In light of recent outbreaks of new respiratory illnesses like pandemic influenza, there is a pressing need for a sustainable and representative pneumonia surveillance program.

Data from the National Syndromic Surveillance for Pneumonia in South Africa 2010 shows that about 1.4 million children died from lower respiratory tract infections (LRTI), and around 12 million were hospitalised.

LRTI is the leading cause of hospital stays for HIV-positive children in sub-Saharan Africa, as these children are more likely to suffer severe cases and higher death rates.

LRTI includes various illnesses such as acute bronchitis, pneumonia, and flare-ups of chronic lung conditions like bronchiectasis and COPD.

Every year, a special day dedicated to fighting pneumonia (29 November) is observed to raise awareness, promote prevention and treatment, and bring the world together for this cause.

The theme for World Pneumonia Day 2024 is “Championing the Fight to Prevent Pneumonia.”

The World Health Organization (WHO) reports that pneumonia remains a leading cause of illness among children in South Africa, even with better immunisation and HIV programs.

Globally, a child dies from pneumonia every 30 seconds, which is more frequent than deaths from malaria, HIV/Aids and tuberculosis, combined.

Pneumonia is a lung infection that inflames the air sacs in one or both lungs. sPicture: Cottonbro studios/pexels

In South Africa, flu and pneumonia are the second biggest cause of death in children under five, coming after intestinal infectious diseases. This situation is troubling, especially since vaccines are available for children in both public and private healthcare sectors.

As part of the Expanded Programme on Immunisation, babies receive vaccinations at four different stages: 2 months, 4 months, 6 months, and 12-15 months.

Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund, explains, “Pneumonia is a lung infection that inflames the air sacs in one or both lungs. These air sacs might fill with fluid or pus, leading to symptoms like a cough with phlegm, fever, chills and difficulty breathing.”

Types of Pneumonia

Bacterial pneumonia

Viral pneumonia

Fungal pneumonia

Aspiration pneumonia, this type often affects older people and individuals with nerve disorders or swallowing problems.

Hadebe advises everyone to get a flu vaccine, calling it the first line of defence against illnesses like pneumonia. Research shows that the flu vaccine reduces your risk of getting the flu by 50 to 60% and also helps in preventing pneumonia.

A study from the New England Journal of Medicine in 2015 states, “Besides lowering the risk of being hospitalised due to the flu itself, the flu vaccine also reduces the chances of flu-related complications like pneumonia.”

However, only 29% of the population is vaccinated against the flu, highlighting the need for better vaccination efforts to prevent pneumonia deaths.

Vaccine for pneumonia

There is a vaccine that protects against pneumonia bacteria, which causes 80% of Community-Acquired Pneumonia (CAPs). These bacteria can spread from the nose, throat, and ears to the lungs, leading to severe infections.

The vaccine also protects against other serious diseases caused by these bacteria, including bloodstream infections (Bacteraemia) and infections of the brain and spinal cord lining (meningitis).

Who should get the pneumococcal vaccine?

People over 65: Especially those living in retirement communities.

Individuals with heart and lung problems: This includes conditions like asthma or chronic illnesses like anaemia, diabetes, or kidney failure.

Immune-suppressed individuals: Including those who are HIV-positive.

Caregivers and close contacts: Those in close contact with anyone from the above groups.

Smokers: They have a higher risk of respiratory illnesses.

Cancer patients: Due to their weakened immune systems.

Signs and symptoms of Pneumonia may include:

Chest pain when you breathe or cough.


Fever, sweating and shaking chills.

Lower than normal body temperature (in adults older than age 65 and people with weak immune systems).

Nausea, vomiting or diarrhoea.

Shortness of breath.

Difficulty breathing, chest pains, persistent fever of (39°C) or higher or a persistent cough, especially if you’re coughing.

Hadebe says that despite strong evidence showing the effectiveness of vaccines, not enough people are getting vaccinated.

“We all need to take charge of our health,” he explains. “This means getting regular wellness checks and making sure you get a flu shot. If you're at risk for pneumonia, get the pneumonia vaccine too.”

He also reminded everyone that their general practitioner (GP) should be the first contact for any health concerns.