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Generating new evidence to support decisions regarding the sustainability of national immunisation for pneumococcal conjugate vaccine (PCV) programs.

Pneumococcal disease is an infection caused by the bacteria, Streptococcus pneumoniae (the pneumococcus).

Pneumococcal disease is an infection caused by the bacteria, Streptococcus pneumoniae (the pneumococcus).

 The National Health and Medical Research Council (NHMRC) Centre of Research Excellence on Asia-Pacific Pneumococcal Disease Control in the PCV Era (CRE-PDC), aims to address two outstanding research gaps for pneumococcal conjugate vaccine (PCV) use in the Asia-Pacific region:

  1. Country decisions regarding reduced dose PCV schedules (1+1), and
  2. Understanding serotype replacement following vaccine introduction.

In addition, the program will forge partnerships with key end-users to ensure research translation, establish new international linkages to enable broader dissemination and develop the next generation of nationally competitive researchers; with provision of capacity building and early career development opportunities and collaboration.

What is pneumococcal disease?

Pneumococcal disease is an infection caused by the bacteria, Streptococcus pneumoniae (the pneumococcus). The pneumococcus commonly lives in the back of the nose without causing symptoms, but may sometimes spread to the lungs, brain, and other organs causing serious diseases such as pneumonia, meningitis or septicaemia (invasive pneumococcal disease).

Why is pneumococcal disease important?

According to the World Health Organization, pneumonia is the single biggest killer of children globally, accounting for the deaths of approximately 1.4 million children aged under five years each year. Pneumonia is more common in South Asia and sub-Saharan Africa.

Why is it important to do surveillance for pneumococcal disease?

Surveillance for pneumococcal disease is important to describe disease trends, monitor changes in the frequency of antimicrobial-resistant strains, describe changes in pneumococcal serotypes (strains), monitor the impact of vaccines on disease, and advise on future vaccine development and the optimal schedule needed to control the disease.

Impact of pneumococcal conjugate vaccines

Surveillance for pneumococcal disease has shown that PCV introduction has resulted in a decline in both carriage and invasive pneumococcal disease due to serotypes covered by the vaccine. However, serotypes not contained in the vaccine have increased (so-called replacement) and the extent to which this occurs is not known in the Asia-Pacific region.

Reduced dose pneumococcal conjugate vaccine schedules

To optimise a schedule, reduce the number of injections, and make space for other vaccines, reducing the schedule from a 3-dose to a 2-dose schedule in countries that have “mature” PCV programs and have pneumococcal vaccine-type disease controlled, could potentially improve the vaccine’s financial sustainability. This strategy is being pursued as part of a global PCV research agenda.

The success of this approach relies on this schedule being able to maintain vaccine-type pneumococcal carriage control, and thereby continue generating herd protection. It is important to identify immunological markers that demonstrate that the reduced schedule is likely to be successful and to provide economic evidence for countries regarding the use of reduced schedules for health policy decision-making.  

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Contact us

Murdoch Children's Research Institute
The Royal Children's Hospital
50 Flemington Road
Parkville VIC 3052