Pneumonia Research and Vaccine Impact League (PREVAIL)

Challenge

India accounts for a disproportionately high fraction of the global pneumococcal disease burden compared with its population size, mostly due to subnational regions of very high rates of disease compared with other states in the country and other countries in the world. The Indian government’s strategy of introducing the pneumococcal conjugate vaccine (PCV) into the national immunization schedule in a phased manner in the highest-burden regions of the country is a bold and welcome step towards reduction of child mortality in India. In order to measure the impact of these vaccination strategies robust surveillance systems need to be established in these high-burden geographic regions.

Approach

PREVAIL is a partnership led by the Johns Hopkins Bloomberg School of Public Health, International Vaccine Access Center (IVAC), in collaboration with Maulana Azad Medical College (MAMC), and is designed to evaluate the impact of PCV introduction in the Indian Universal Immunization Program (UIP). The primary aim is to determine the impact of PCV by measuring differences in vaccine-serotype colonization among hospitalized children aged 1-35 months, as well as differences among healthy community children 1-35 months, comparing those enrolled at sites where PCV has been introduced to those at sites where PCV has not yet been introduced. This study will establish and maintain a surveillance network in five Indian states to measure the impact of routine infant vaccination with PCV on serotypes causing invasive pneumococcal disease (IPD) among young children under 5 years of age in India. We also aim to fill evidence gaps by documenting and quantifying the economic value of disease control provided by PCV use, by estimating costs associated with pneumonia disease and pneumonia hospitalization. Key activities to be established in India include leadership in surveillance activities, robust data management systems and data dissemination activities.

Results

With coordinated efforts to establish surveillance and perform impact evaluation of the sub-national PCV rollout, data needed to inform policy and sustain the PCV rollout will be made available to support Indian policy makers as the country makes good progress in reaching global priorities set for reducing childhood mortality