Pneumococcal Conjugate Vaccines in India: Reviewing Disease Burden, Serotypes, Vaccine Choice and Dosing Schedules

India has almost a quarter of the global childhood pneumonia burden, with an estimated 8 million severe cases, more than 50% of whom need hospitalization or even intensive care, constituting a huge health burden. India sees at least 0.1 million deaths due to pneumococcal infections every year in children below 5 years of age. Fatality rates in pneumococcal infections are overall 6-7%, ranging from 11% in severe cases to 60% in hospitalized cases and invasive pneumococcal disease (IPD). Almost half of pneumococcal infections show resistance to antibiotics, and therefore prevention via vaccination is the best approach. The inclusion of pneumococcal vaccination in the Universal Immunization Programme (UIP) of India in 2017 has been a required and welcome move. The purpose of this article is to review the pneumonia burden, pneumococcal serotypes in India, and the various available pneumococcal conjugate vaccines (PCVs) with their features and coverage to understand clinical relevance and make informed decisions. Further areas of research include impact studies of PCV in India, as well as evolving serotype prevalence for developing future relevant vaccines.