Progress in introduction of pneumococcal conjugate vaccine - worldwide, 2000-2012

Abstract

Pneumococcal conjugate vaccines (PCVs) are safe and effective for reducing illness and deaths caused by Streptococcus pneumoniae. Recommendations for PCV use from the World Health Organization (WHO) and funding from the GAVI Alliance have resulted in an increase in PCV introductions into national immunization programs, especially in lower-income countries. Additionally, new formulations that cover more serotypes commonly causing disease in lower- and middle-income countries have become available. This report uses WHO data from 2000-2012, stratified by country disease burden characteristics and World Bank country income groups, to describe global progress in PCV introduction. As of December 2012, a total of 86 (44%) WHO member states have added PCV to the routine infant immunization schedule of their national immunization programs; among those, 23 have introduced PCV with GAVI Alliance support. PCV introduction among WHO member states was most common in the Americas Region (60% of member states), followed by the Eastern Mediterranean Region (50%), European Region (49%), African Region (41%), and Western Pacific Region (33%); none of 11 WHO member states in the South-East Asia Region have introduced PCV. Proportions of low- and middle-income countries with PCV introductions were similar. The proportion of the world's birth cohort living in countries with PCV in national immunization programs increased from 1% in 2000 to 31% in 2012. These findings suggest that efforts to increase PCV introduction and use globally are succeeding; however, gaps in PCV use remain in Asia and countries with large birth cohorts, where concerted efforts should be focused.

FIGURE 1

Progress of pneumococcal conjugate vaccine (PCV) introductions and proportions of birth cohorts living in countries that have introduced PCV into routine infant immunization schedules, by year — World Health Organization (WHO), worldwide, 2000–2012 Abbreviations: PCV7 = 7-valent PCV; PCV10 = 10-valent PCV; PCV13 = 13-valent PCV.

FIGURE 2

Countries that have introduced pneumococcal conjugate vaccines in their national Immunization programs, by income status^* — worldwide, 2012 Data sources: World Health Organization/Immunization Vaccines and Biologicals/Expanded Programme on Immunization 2013 database, and World Bank list of economies (July 2012). ^* World Bank income groups are defined (in U.S. dollars) as follows: high-income countries = countries with a 2011 gross national income (GNI) per capita ≥$12,476; upper-middle income countries = countries with a 2011 GNI <$12,476 and ≥$4,036; lower-middle income countries = countries with a 2011 GNI <$4,035 and ≥$1,027; and low-income countries = countries with a 2011 GNI ≤$1,026. No income status was reported for Niue. Additional information is available at http://data.worldbank.org/indicator/ny.gnp.pcap.cd.