Global Pneumococcal Disease and Vaccine

Global Pneumococcal Disease

Streptococcus pneumoniae (pneumococcus) can cause serious infections such as pneumonia, meningitis, and bloodstream infection. Based on available data, the World Health Organization (WHO) estimates that S. pneumoniae kills close to half a million children under 5 years old worldwide every year, with most of these deaths occurring in developing countries.

Respiratory infections, especially pneumonia, are a leading cause of childhood mortality worldwide. S. pneumoniae is the leading cause of pneumonia mortality globally, and accounted for more deaths than all other causes (etiologies) combined in 2016.1 Most of these deaths occur in countries in Africa and Asia.

Pneumococcal Vaccine

The U.S. Food and Drug Administration first licensed pneumococcal conjugate vaccine (PCV) for infant use in the United States in 2000. In 2007, WHO published a position paperCdc-pdfExternal recommending all countries include PCV as part of the routine infant immunization schedule. There are currently two formulations of PCV in the market: 10-valent PCV and 13-valent PCV. WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization recommends both formulations.

Countries that introduced PCV have observed large reductions in severe (invasive) pneumococcal disease and pneumonia. As of March 2018, 142 countries out of 194 WHO member states have introduced PCV into their National Immunization Program either nationally or sub-nationally. High-income countries were the early adopters of PCV. With the support from Gavi, The Vaccine AllianceExternal, many low-income countries have been able to introduce PCV into their national immunization program. Despite this progress, 53% (approximately 71 million) of the global infant population are still not receiving PCV.2

Figure. A total of 142 countries have introduced PCV from 2000 through 2018. Of the 73 Gavi-eligible countries, 59 (81%) introduced PCV. Among non-Gavi eligible countries, PCV has been introduced in 6 (50%) of 12 lower middle-income countries, 26 (51%) of 51 upper middle-income countries, and 51 (88%) of 58 high-income countries. Figure courtesy of the International Vaccine Access Center (IVAC).

Figure. A total of 142 countries have introduced PCV from 2000 through 2018. Of the 73 Gavi-eligible countries, 59 (81%) introduced PCV. Among non-Gavi eligible countries, PCV has been introduced in 6 (50%) of 12 lower middle-income countries, 26 (51%) of 51 upper middle-income countries, and 51 (88%) of 58 high-income countries. Figure courtesy of the International Vaccine Access Center (IVAC).

1 GBD 2016 Lower Respiratory Infections Collaborators. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016External. Lancet Infect Dis. 2018 Sep 19. pii: S1473-3099(18)30310-4. doi: 10.1016/S1473-3099(18)30310-4.

2 Johns Hopkins Bloomberg School of Public Health International Vaccine Access Center (IVAC). View-hub report: Global vaccine introduction and Implementation, March 2018Cdc-pdfExternal.

CDC Global Activities with Pneumococcus

In collaboration with WHO, Ministries of Health, and other international partners, CDC helps to strengthen surveillance and laboratory capacity to describe disease burden and monitor emergence of non-vaccine serotypes. Additional efforts include conducting PCV impact evaluations to inform and sustain the use of PCV globally.

Global Pneumococcus Resources

Literature

Page last reviewed: November 15, 2018