India’s introduction of the pneumococcal conjugate vaccine (PCV) represents a landmark achievement in its efforts to reduce childhood mortality. From local pilots in high-burden provinces to a full nationwide rollout, the case also highlights the integrated supporting system that made this possible: surveillance and evidence generation, community mobilization, supply-chain strengthening, and successful product-switch management.
The pre-introduction phase was shaped by substantial national and global evidence demonstrating PCV’s effectiveness against invasive pneumococcal disease. India’s National Technical Advisory Group on Immunization endorsed a phased implementation of the Universal Immunization Programme (UIP), ensuring equitable access beyond the private sector. A WHO-prequalified PCV13 was initially selected, following a 2+1 dosing schedule aligned with UIP norms.
Between 2017 and 2020, PCV was rolled out incrementally across five high-burden states. This phased strategy enabled India to develop operational experience while strengthening its cold-chain infrastructure, training systems, and communication channels. Community engagement relied on mass media, local health networks, and culturally adapted messaging, while early surveillance activities provided evidence to guide scale-up. By 2020, nearly half of India’s birth cohort had geographical access to PCV.
A key turning point was the development of the affordable Indian-made PCV10. Its availability enabled rapid expansion to all 36 states and union territories in 2021, despite the challenges of the COVID-19 pandemic. India adopted innovative tools such as PROMPT, a digital preparedness assessment platform, hybrid online/offline training in 13 languages, WhatsApp-based dissemination of FAQs and guidelines, and real-time supply-chain monitoring via the eVIN system. These measures helped maintain momentum despite travel restrictions and logistical disruptions.
Post-introduction outcomes demonstrate a significant public health impact. PCV booster coverage rose sharply, reaching 83% in 2023. India’s GAPPD indicators for pneumonia improved markedly, and under-five deaths from pneumonia and diarrhea declined by more than 50% between 2016 and 2024. The vaccine is estimated to save over 330,000 young lives annually. Additionally, India successfully transitioned from PCV13 to indigenous PCV10 and later PCV14, strengthening long-term financial sustainability.
India’s PCV journey underscores several lessons: prioritize high-burden populations, ensure sustainable financing, integrate digital systems into immunization programs, and maintain strong coordination between political and technical actors. Future research should further assess the vaccine’s impact on antimicrobial resistance, healthcare utilization, and equity in vaccine uptake to maximize the benefits of this nationwide investment fully.
Content Editor: Xinyue Zhou
Page Editor: Ruitong Li
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Kumar, P., Ray, A., Kumari, A., Sultana, A., Hora, R., Singh, K., Mehra, R., Kaur, A., Koshal, S. S., Quadri, S. F., Singh, S. K., & Roy, A. D. (2025). Chronicling the Journey of Pneumococcal Conjugate Vaccine Introduction in India. Vaccines, 13(4), 432. https://doi.org/10.3390/vaccines13040432
