India is one among the four Asian countries with the greatest number of deaths due to pneumococcal infection among children under 5 years. pneumococcal conjugate vaccine (PCV) has been introduced in a phased manner in five major Indian states. Ambiguity remains in choosing the appropriate type of PCV and optimum schedule with maximum effectiveness specific for each country. Here, we discuss the evidences with respect to serotype coverage, immunogenicity, reactogenicity and dosage schedule for introduction of PCV13 in India. In addition, the expected PCV impact and the challenges are detailed. PCV13 is expected to provide >75% serotype coverage for invasive pneumococcal disease (IPD) serotypes in Indian children combined with the replacement by nonvaccine serotypes which is unpredictable due to lack of complete data. Nasopharyngeal (NP) surveillance is easy, feasible and can replace IPD surveillance in resource-poor settings. Continuous IPD as well as NP surveillance in all the regions are necessary to assess the impact of PCV in India.

中文翻译：

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印度肺炎球菌结合疫苗的推出：期望和挑战。

印度是5岁以下儿童肺炎球菌感染死亡人数最多的四个亚洲国家之一。肺炎球菌结合疫苗（PCV）已在印度五个主要邦分阶段推出。对于每个国家来说，选择适当的 PCV 类型和具有最大有效性的最佳时间表仍然存在模糊性。在这里，我们讨论在印度引入 PCV13 的血清型覆盖率、免疫原性、反应原性和剂量方案方面的证据。此外，还详细介绍了预期的 PCV 影响和挑战。PCV13 预计将为印度儿童的侵袭性肺炎球菌病 (IPD) 血清型提供 >75% 的血清型覆盖率，并用非疫苗血清型替代，但由于缺乏完整的数据，这种情况是不可预测的。鼻咽 (NP) 监测简单、可行，可以在资源匮乏的环境中取代 IPD 监测。为了评估 PCV 在印度的影响，有必要在所有地区进行持续的 IPD 和 NP 监测。