Progress towards reduced-dose pneumococcal vaccine schedules for children in Africa.

Pneumococcal conjugate vaccines (PCVs) have been available for more than 20 years 1 Wahl B O'Brien KL Greenbaum A et al. Burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in the era of conjugate vaccines: global, regional, and national estimates for 2000–15. Lancet Glob Health. 2018; 6: e744-e757 Summary Full Text Full Text PDF PubMed Scopus (522) Google Scholar and incorporated into the childhood immunisation programmes of 168 countries. Although they have been remarkably successful at reducing the burden of pneumococcal disease globally, 1 Wahl B O'Brien KL Greenbaum A et al. Burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in the era of conjugate vaccines: global, regional, and national estimates for 2000–15. Lancet Glob Health. 2018; 6: e744-e757 Summary Full Text Full Text PDF PubMed Scopus (522) Google Scholar there remain concerns about the sustainability of PCV programmes given the emerging threats and competing public health interests. Importantly, PCV remains the most expensive vaccine in childhood immunisation programmes, and between 2009 and 2020 Gavi, the Vaccine Alliance spent more than US$4 billion on PCV alone. In 2021, all but nine African nations had introduced PCV, with the high cost being a major barrier to introduction. Single priming and booster dose of ten-valent and 13-valent pneumococcal conjugate vaccines and Streptococcus pneumoniae colonisation in children in South Africa: a single-centre, open-label, randomised trialThe serotype-specific colonisation data reported in this study together with the primary immunogenicity endpoints of the control trial support transitioning to a reduced 1 + 1 schedule in South Africa. Ongoing monitoring of colonisation should, however, be undertaken immediately before and after transitioning to a PCV 1 + 1 schedule to serve as an early indicator of whether PCV 1 + 1 could lead to an increase in vaccine-serotype disease. Full-Text PDF Open Access