Objective To analyze immunization schedules of pneumococcal conjugate vaccine (PCV) and pneumococcal polysaccharide vaccine (PPV) in the 140 member states of World Health Organization (WHO) and to provide evidences to optimizing pneumococcal vaccine vaccination strategy in China.
Methods We collected publicly-accessible relevant data updated till February 28, 2018 from the WHO website and then analyzed vaccine type, number of doses, recommended ages for each dose and region distribution of PCV and PPV among the 140 member states of WHO.
Results Among the 140 WHO member states, 118 (60.8%) and 21 (15.0%) states adopted three- and four-doses PCV immunization schedule; only one state used five or more doses immunization schedule. Of the 118 member states with 3 doses PCV vaccination schedule, 59 (50.0%) and 47 (39.8%) administered the first dose when the infants aged 2 and 1.5 months; of the 81 states with 3 doses PCV as both full and primary immunization or with 4 or more doses as full immunization, 44 (54.3%) administered the second dose when the infants aged 2.5 months and 43 (53.1%) administered the third dose when the infants aged 3.5 months; of the 59 states with 3 doses PCV as the full immunization of two primary immunization plus one booster immunization, 40 (67.8%) administered the second dose when the infants aged 4 months and 39 (66.1%) administered the third dose when the infants aged 12 months; of the 22 states with 4 or more doses of PCV as full immunization, 6 (27.3%) and 5 (22.7%) administered the fourth dose when the infants aged 15 and 18 months. Among the 40 member states with PPV vaccination schedule, 17 (42.5%), 13 (32.5%), 7 (17.5%), and 3 (7.5%) were in WHO division of Region for the Europe (EUR), Americas (AMR), Western Pacific (WPR), and Eastern Mediterranean (EMR), respectively; the majority of the states adopted one dose of PPV vaccination schedule and 22 (55.0%) of the states administered the one dose PPV to the population aged 50 years or older.
Conclusion The routine PCV immunization schedules adopted by the140 member states of WHO include 3-dose of primary immunization, 2-dose of primary plus 1-dose of booster immunization, and 3-dose of primary plus 1-dose of booster immunization based on the prevalence of pneumococcal pneumonia. One dose of PPV vaccination is the schedule adopted by the majority of the member states. China can establish PCV immunization strategies according to the epidemic and characteristics of pneumococcal diseases in the country.