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WHO approves Serum Institute pneumococcal conjugate vaccine for 2+1 schedule
In March 2023, the World Health Organization (WHO) approved an update to the package insert for the 10-valent pneumococcal conjugate vaccine (PCV), Pneumosil®, to add an indication for administration in two primary doses and a booster dose (2+1) at 6 weeks, 14 weeks, and 9-18 months. The vaccine is already indicated for the other WHO-approved PCV schedule of three primary doses (3+0) as well as a 3+1 schedule. Phase 3 clinical studies in India and The Gambia informed the 2+1 approval, including a PATH-sponsored study conducted by the Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine that directly compared Pneumosil with other WHO-prequalified PCVs and demonstrated the vaccine's safety and immunogenicity when given to infants in a 2+1 schedule.
Developed by Serum Institute of India, Pvt. Ltd. in collaboration with PATH, Pneumosil is one of three WHO-prequalified PCVs on the global market against Streptococcus pneumoniae—a top cause of childhood pneumonia, meningitis, sepsis, and otitis media. For PCVs, a 2+1 schedule has theoretical advantages compared to 3+0 because the longer intervals between doses may enable a longer lasting immunity. With both schedules now approved for Pneumosil, countries will have more options when considering PCV use and scheduling within their specific routine immunization contexts. In India, Pneumosil is being used in a 2+1 schedule across all states and union territories as part of the Universal Immunization Program since April 2021.
Phased expansion of malaria vaccine begins in more areas in Africa
Expansion of malaria vaccination is underway in more areas in sub-Saharan Africa. Ghana, Kenya, and Malawi, which began piloting the RTS,S/AS01 malaria vaccine in selected areas in 2019, started phased expansion to additional children in the pilot areas. PATH, through a grant from US-based Open Philanthropy, will support scale-up of malaria vaccine use through 2023, using vaccine doses donated by GlaxoSmithKline, the manufacturer, and in collaboration with WHO and other in-country partners. For additional countries, phased introduction of malaria vaccination could begin as soon as late 2023. A dozen African countries have applied to Gavi, the Vaccine Alliance, for support for subnational introduction.
In light of the strong interest in malaria vaccination from African countries, Gavi and partners—including PATH—continue to work toward increasing supply as rapidly as possible. In January, Gavi published a public summary of its first Market Shaping Roadmap for Malaria Vaccines that highlights the need for an intervention to achieve a healthy market—one in which supply meets demand, the supplier base is diversified, demand for the vaccine is clearly understood, and product improvements and innovation are supported. While efforts are already underway to achieve some of the Roadmap’s objectives, additional resources will be needed to advance others, such as improvements to existing products or transfer of production to Africa. 
PATH and partners work to maintain high prioritization for Japanese encephalitis prevention and management in Bangladesh
Japanese encephalitis (JE) is endemic in Bangladesh where one in four patients may die from this mosquito-borne disease. While national decision-makers recently decided to introduce JE vaccine in specific divisions, PATH continues to work with local partners on information sharing about JE and the devastating impact of the disease on local families. PATH, alongside the Institute of Epidemiology, Disease Control and Research (IEDCR), icddr,b, and the Expanded Programme on Immunization (EPI), has conducted cost of illness and cost-effectiveness studies to provide further data about the impact of JE—and the importance of JE vaccine—in Bangladesh.
During the past three months, Bangladesh EPI, with support from icddr,b and PATH, organized three divisional-level workshops to disseminate information about the cost of JE illness and its health consequences, and to raise awareness of the short- and long-term burdens that families bear after a case of JE. Meeting discussions focused on informing decision-makers about the impact on families and society, including the costs of acute and long-term care for the healthcare system and for households, loss of income and productivity, and to highlight the importance of preventing JE in Bangladesh.
In early March, PATH, EPI, and icddr,b hosted a meeting with the technical working group, including policymakers from the Ministry of Health and development partners to validate the cost-effectiveness analysis of various JE vaccine delivery strategies (compared to no vaccination). Meeting participants were given an opportunity to input into the delivery strategies included the analysis and share feedback on model parameter values. The alignment achieved from this meeting is critical for finalizing the cost-effectiveness analysis results, which will be shared with all stakeholders to support policymakers and donors in making informed decisions on JE vaccination strategies in the future.
CCAE and PATH co-host a policy dialogue on single-dose HPV vaccination
In late February, the Cervical Cancer Action for Elimination Network (CCAE) held the first of a series of virtual policy dialogues to discuss key questions on human papillomavirus virus (HPV) vaccination and its role in preventing cervical cancer. This session, co-hosted by PATH, discussed key questions and the compelling evidence for single-dose HPV vaccine efficacy, implementation, and advocacy in light of WHO’s endorsement of a single-dose schedule. View a summary of the discussion and learn more about CCAE’s next installment in the series. |
