Chronicling the Journey of Pneumococcal Conjugate Vaccine Introduction in India

Background: Pneumonia is one of the leading causes of death in under-5 children in India. The phased rollout, which began in high-burden states and was completed nationwide by 2021, was a major initiative by the Ministry of Health and Family Welfare (MoHFW). Despite challenges posed by the COVID-19 pandemic, which affected logistics and required creative solutions, the campaign succeeded in maintaining progress and achieving nationwide coverage. This narrative review highlights the significant decisions, dedication and coordinated efforts of various stakeholders involved that led to accomplishment of successful PCV rollout. Methodology: A comprehensive desk review of both published and unpublished literature relevant to the burden of pneumonia, pneumococcal pneumonia mortality in children under five, the efficacy and effectiveness of Pneumococcal Conjugate Vaccines (PCVs), and the documentation of PCV introduction and scale-up in India was carried out. Results: The documentation of PCV journey has been broken down in four sections: pre-introduction, PCV Phase I introduction, Pan India rapid expansion, and post-introduction. Since the nationwide rollout in 2021, PCV coverage in India has steadily increased reflecting successful immunization efforts. The WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) also show a positive trend in vaccination coverage, which aligns with the goals of the WHO and UNICEF’s Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD). Conclusion: The phased rollout, starting with high-burden states and completing nationwide expansion by 2021, was an ambitious effort by the Ministry of Health and Family Welfare (MoHFW), particularly challenging given the overlap with the COVID-19 pandemic. Despite these hurdles, the MoHFW, with strong collaboration from development partners and stakeholders, successfully navigated the complex rollout. This is a noteworthy achievement considering the unprecedented scale of the COVID-19 vaccination drive that was simultaneously ongoing.