Streptococcus pneumoniae (Pneumococcus)
Two trials in Africa have demonstrated that a nine valent vaccine significantly reduces rates of pneumonia and, in populations with limited access to curative health services, also in reduction in mortality. More information on the distribution of serotypes is required to confirm that these vaccines will indeed cover the important serotypes in all regions. Furthermore, as with other new vaccines, pneumococcal vaccines are likely to be substantially more expensive than the current EPI vaccines. Therefore, a strong economic case will be required to convince governments and donors about vaccine introduction, which involves estimating local disease burden and vaccine cost-effectiveness.
Once the vaccine has been introduced continued surveillance documenting the vaccine’s impact on disease will be required to sustain the vaccine program. This will be especially important for countries who are first to introduce the vaccine. Surveillance should be conducted both in vaccinated and unvaccinated persons in order to assess the beneficial effects of herd immunity and the risks of serotype replacement. These factors underline the need to strengthen surveillance systems at regional and national levels.