Status of introduction of pneumococcal conjugate vaccine in Pakistan

Streptococcus pneumoniae infection causes a wide spectrum of diseases ranging from acute otitis media to Invasive Pneumococcal Disease (IPD) presenting as pneumonia, meningitis, joint effusions, bacteraemia and septicaemia. Pakistan was the first country in the South Asian region to introduce PCV-10 within the routine immunisation program. Government of Pakistan, with support from Gavi, the Vaccine Alliance and other partners, introduced PCV-10 in phased manner, starting October 2012. Vaccination schedules matched other age-appropriate vaccines offered within existing Routine Immunisation (RI) schedules and were offered at 6, 10 and 14 weeks after birth. Catch up immunization was not done. Few studies conducted before vaccine introduction showed that the burden of IPD and the serotype distribution was similar to other countries in the region. The selection of PCV-10 instead of PCV-13 in Pakistan's Expanded Programme for Immunization (EPI) was based largely on earlier availability of PCV-10, and the impression that there would be marginal gain in serotype coverage from a higher valence vaccine. A few studies are currently underway to assess the impact of PCV introduction in Pakistan's EPI.