​Important Update to Pneumococcal Conjugate Vaccine (PCV) Dosing Schedules 2025

Updated Pneumococcal Conjugate Vaccine (PCV) Dosing Schedules 

In March 2025, WHO’s Strategic Advisory Group of Experts (SAGE) updated its position paper on the pneumococcal conjugate vaccine (PCV), now recommending a 2-dose schedule. This important change has significant implications for global vaccine programs, including Gavi’s $1.5 billion five-year PCV investment and the immunisation budgets of many low- and middle-income countries (LMICs). 

​A 2-dose schedule offers a more efficient, affordable option that is highly suitable for many Pacific Island Countries and LMICs across our region. This development will be a key focus at our upcoming Centre for Research Excellence (CRE) Pneumococcal Disease Control in the Asia-Pacific Forum. 

​At Melbourne Children’s Global Health, we are proud to have played a leading role in the research that shaped this policy evolution: 

·       ​Pioneering RCT in Fiji (2003–2009): 
In partnership with Fiji’s Ministry of Health and Fiji School of Medicine, Fiona Russell led the first randomized controlled trial comparing 1-, 2-, and 3-dose PCV schedules. This NHMRC- and US NIAID-funded research, conducted by our team including Kim Mulholland and Jonathan Carapetis, directly informed WHO’s 2012 PCV policy and sparked global investments, including from the Gates Foundation. 

·       ​Further Global Trials: 
Our teams also led major 2- versus 3-dose PCV trials in Vietnam and The Gambia, which have provided crucial evidence to guide the 2025 WHO recommendations. 

·       ​New Trials on Affordable Pneumosil Vaccine: 
Addressing current evidence gaps, we designed and are overseeing two randomized controlled trials of Pneumosil — the world’s most affordable PCV — in Thailand and Vietnam. 

​Successful implementation of a reduced-dose schedule depends on continued indirect protection and robust surveillance: 

·       ​Budget Impact and Cost-Effectiveness Work: 
Fiji is the first country to complete a budget and cost-effectiveness analysis comparing 2- and 3-dose schedules, supported by Australia’s DFAT. Similar analyses are underway in Lao PDR, Thailand, and other LMICs to facilitate timely adoption of the new WHO recommendations. 

·       ​Enhancing Pneumococcal Surveillance: 
Recognising challenges in invasive disease surveillance in many LMICs, Fiona Russell and Catherine Satzke are leading the development of WHO’s 2025 update of pneumococcal carriage surveillance guidelines.  

​Melbourne Children’s Global Health is honoured to contribute significantly to one of the most important childhood vaccines globally, the PCV vaccine. Our work exemplifies Australia’s leadership in improving vaccine policy and child health outcomes across the Asia-Pacific region and worldwide. 

​Our 2022 CRE Forum, co-funded by the Gates Foundation, brought together seven LMIC policymakers, DFAT, WHO SAGE, UNICEF, ATAGI, the Gates Foundation, and nearly 300 participants from 28 countries — reflecting the global scale and importance of this work.