The World Health Organization (WHO) recommends the introduction of pneumococcal vaccines into the immunization schedules of all member states. By the end of 2023, 166 countries had done so, with a global coverage rate of approximately 65% for the final PCV dose. Among countries that have introduced PCV, there are 62 high-income countries (31.96%) and 26 low-income countries (13.40%). Of the 28 countries that have not yet introduced PCV into their national immunization programs (NIP), middle-income countries takes the highest proportion, at 67.86% (Table 1).1
Table 1 Number of countries incorporating PCV into national immunization schedules n (%)
| Classification of immunization programmes | World Bank Country Income Classification | Number of countries | |||
| High-income countries | Middle-income countries | Low-income countries | Other* | ||
| Included in NIPs | 57 (35.85) | 79 (49.69) | 21 (13.21） | 2（1.26) | 159 (81.96) |
| For high-risk groups | 2 (28.57) | 5 (71.43) | 0 (0.00） | 0（0.00) | 7 (3.61) |
| Not included | 3 (10.71) | 19 (67.86) | 5 (17.86） | 1（3.57) | 28 (14.43) |
| Total | 62 (31.96) | 103 (53.09) | 26 (13.40） | 3（1.55) | 194 (100.00) |
*Other: Cook Islands, Niue are not included in the World Bank Country Income Classification; Venezuela is not yet classified
The temporal division of immunization schedules based on 2010 (the year PCV13 launched globally) showed that high-income countries had the highest PCV vaccine introduction rate before 2009. Low-income countries had the highest immunization introduction rate after 2010. Around 70% of countries had included PCV vaccine in their national immunization programs after 2010 (Table 2).
Table 2 Year of PCV introduction by country income level, n(%)
| Incorporation of time classification | World Bank Country Income Classification | Total | ||||
| High-income countries | Upper middle-income countries | Lower middle-income countries | Low-income countries | Other | ||
| 2000-2009 | 34 (77.27%) | 6 (13.64%) | 2 (4.55%) | 1 (2.27%) | 1 (2.27%)* | 44 (29.93%) |
| 2010-2020 | 17 (16.50%) | 27 (26.21%) | 19 (18.45%) | 40 (38.83%) | 0 (0.00%) | 103 (70.07%) |
| *Niue incorporated PCV vaccine into the national immunization programme in 2009 | ||||||
Immunization schedules varied among countries. Based on a survey in 2018, 118 of WHO’s 140 Member States implemented 3-dose PCV immunization schedule, 21 countries implementing a 4-dose PCV immunization schedule, and 1 country implementing a ≥5-dose PCV immunization schedule. Most countries in the African Zone chose a 3-dose primary immunization with a starting age of 1.5 months, while most countries in the American Region and the European Region chose a 2 primary doses schedule with 1-dose booster, often starting at age of 2 months.2
Content Editor: Menglu Jiang, Ziqi Liu
Page Editor: Ziqi Liu
References
- World Health Organization. Introduction of PCV (Pneumococcal conjugate vaccine) [EB/OL].[2024-07-30]. https://immunizationdata.who.int/global/wiise-detail-page/introduction-of-pcv-(pneumococcal-conjugate-vaccine)?ISO_3_CODE=&YEAR=
- Wu D, Ning G, Li J, Yin Z, Li Y. Vaccination schedules of PCV and PPV in 140 member states of World Health Organization. Chinese Journal of Public Health,2018,34(11):1476-1479.
