Pneumococcal disease (PD) causes substantial morbidity and mortality among children worldwide, with low- and middle-income countries in Asia and Africa bearing a disproportionate burden. Pneumococcal conjugate vaccines (PCVs) have become one of the most effective interventions for preventing invasive pneumococcal disease (IPD), pneumonia, and other severe infections while generating herd immunity and reducing healthcare costs. A recent systematic review published in Human Vaccines & Immunotherapeutics examined pediatric PCV implementation across 14 Asia-Pacific areas, comparing national immunization program (NIP) inclusion, financing mechanisms, vaccination schedules, and post-introduction epidemiological outcomes. The findings may also provide useful context for future pediatric PCV policy discussions in China.
As of June 2025, 11 of the 14 surveyed countries and regions had incorporated PCVs into their pediatric NIPs with full government funding for eligible children, whereas pediatric pneumococcal vaccination was not part of the NIP in Mainland China, Thailand, or Vietnam. Considerable heterogeneity exists in vaccine products and immunization strategies. Countries employ different formulations, including PCV10, PCV13, PCV15, and PCV20, while PPSV23 is recommended for selected high-risk children in several settings. Vaccination schedules also vary, with most countries adopting either a 2+1 or 3+1 schedule, whereas the Philippines implements a 3+0 regimen. In addition, recommendations for catch-up vaccination and high-risk populations differ substantially, reflecting diverse epidemiological patterns, healthcare capacities, and policy priorities rather than a uniform regional approach.
Available evidence generally indicates reductions in IPD incidence following PCV introduction. Countries with established pediatric PCV programs, particularly Australia and Japan, have reported marked declines in IPD incidence among young children following vaccine implementation. Progressive reductions were observed after the transition from PCV7 to higher-valency vaccines such as PCV13, accompanied by significant decreases in pneumococcal meningitis and vaccine-serotype disease. Overall, these findings support an association between pediatric PCV introduction and reductions in IPD incidence, although the magnitude and durability of benefit vary across settings and remain incompletely characterized.
Nevertheless, the review emphasizes that successful PCV implementation requires continuous surveillance beyond overall disease reduction. Serotype replacement has emerged as a persistent challenge, with non-vaccine serotypes increasing in prevalence after widespread vaccination. In Hong Kong SAR, serotype 3 increased in the post-PCV13 period despite its inclusion in PCV13. In New Zealand, vaccine-type nasopharyngeal carriage decreased while non-vaccine-type carriage increased after PCV introduction. These observations highlight the importance of maintaining robust surveillance systems to monitor serotype dynamics, evaluate vaccine effectiveness, and support timely adjustments to vaccine composition and immunization policies.
For China, the Asia-Pacific experience provides important policy insights rather than a single implementation model. Decisions regarding NIP inclusion should integrate local disease burden, serotype distribution, economic feasibility, and health system capacity. The review notes that the cost of higher-valent PCVs, uncertainty regarding their incremental benefit in specific serotype landscapes, and limited national surveillance data may complicate policy decisions. For China, strengthening disease surveillance and generating high-quality local evidence would help inform future assessments of the potential health and economic value of NIP introduction.<\/p>\n\n\n\n
Relevant Research:
Zaidi O, Choi EH, Ip M, Yamada E, Du F, Bernauer M, Kim JO, Sukarom I. Systematic literature review on pneumococcal vaccination recommendations in national immunization programs for the pediatric population in select areas in the Asia Pacific region. Human Vaccines & Immunotherapeutics. 2026;22(1):2661118. doi:10.1080\/21645515.2026.2661118
https:\/\/doi.org\/10.1080\/21645515.2026.2661118<\/p>\n\n\n\n
Translating and summarizing: Tianyi Deng
Reviwer: Ziqi Liu
Page editor : Ruitong Li<\/p>\n","protected":false},"excerpt":{"rendered":"
Pneumococcal disease (PD) causes substantial morbidity and mortality among children worldwide, with low- and middle-income countries in Asia and Africa bearing a disproportionate burden. Pneumococcal conjugate vaccines (PCVs) have become one of the most effective interventions for preventing invasive pneumococcal disease (IPD), pneumonia, and other severe infections while generating herd immunity and reducing healthcare costs. […]<\/p>\n","protected":false},"featured_media":16760,"menu_order":0,"template":"","meta":{"type_label":"none_selected"},"news-category":[73],"class_list":["post-16823","project-news","type-project-news","status-publish","has-post-thumbnail","hentry","news-category-research-en"],"_links":{"self":[{"href":"https:\/\/vaxlab.dukekunshan.edu.cn\/en\/wp-json\/wp\/v2\/project-news\/16823","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vaxlab.dukekunshan.edu.cn\/en\/wp-json\/wp\/v2\/project-news"}],"about":[{"href":"https:\/\/vaxlab.dukekunshan.edu.cn\/en\/wp-json\/wp\/v2\/types\/project-news"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vaxlab.dukekunshan.edu.cn\/en\/wp-json\/wp\/v2\/media\/16760"}],"wp:attachment":[{"href":"https:\/\/vaxlab.dukekunshan.edu.cn\/en\/wp-json\/wp\/v2\/media?parent=16823"}],"wp:term":[{"taxonomy":"news-category","embeddable":true,"href":"https:\/\/vaxlab.dukekunshan.edu.cn\/en\/wp-json\/wp\/v2\/news-category?post=16823"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}