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Using PCV Impact Evidence to Inform Policy

Challenge

Pneumococcal conjugate vaccines (PCVs) are recommended for all countries’ childhood routine immunization system by the WHO to prevent diseases like pneumonia, meningitis, and otitis media. PCVs are currently available as two different products, administered in multiple types of schedules. PCV use is widespread globally, but many questions remain about how to optimize pneumococcal vaccination strategies in order to maximize impact, especially the context of evolving disease epidemiology and burden.

Approach

Meeting of the strategic Advisory Group of Experts on Immunization (SAGE) PCV Working Group

IVAC has partnered with other collaborators, including the US CDC and the World Health Organization (WHO) to systematically review and synthesize PCV impact evidence to inform vaccine policy. The PCV Technical Coordination Project team embarked on the PCV Review of Impact Evidence (PRIME) to analyze available evidence comparing the impact of different PCV products (PCV10 and PCV13) and schedules (2+1 and 3+0) for a variety outcomes including immunogenicity, nasopharyngeal carriage, invasive pneumococcal disease, pneumonia, mortality, and otitis media. The PSERENADE project is estimating the impact of long-term use of PCV on invasive pneumococcal disease, including on replacement disease caused by non-vaccine-type strains and indirect protection in unvaccinated adults. In collaboration with colleagues at University College London, the effect of age on immunogenicity of both PCVs and polysaccharide vaccines is being evaluated in older adults to inform policy on adult immunization programs.

The results have directly informed the Strategic Advisory Group of Experts on Immunization (SAGE) PCV Working Group to revise and devlop recommendations on global PCV use.

Additionally, the IVAC team has developed an online, publicly accessible resource called VIEW-hub to maintain an up-to-date database of PCV impact evidence. VIEW-hub informs assessments of current data gaps in PCV impact evidence with the goal of supporting policy makers and global health partners in shaping future strategic research and decision making on PCV use.

Results

Publicly available reports of PCV impact evidence are available on the WHO website. Peer-reviewed publications are anticipated in 2021. The team’s work also shaped the WHO position paper on PCV immunization.