At the Joint Committee on Vaccination and Immunisation (JCVI) meeting in February 2025, the Committee discussed the use of different available vaccines in the infant pneumococcal vaccination schedule. The JCVI considered that the modelling that was presented at the time suggested there should be a preference for PCV20 in the current 1+1 schedule, provided it could be obtained at a cost-effective price, and that PCV13 and PCV15 could be considered equivalent to each other and suitable for use.

Following the meeting, and in discussions with the Chair, it was agreed that the JCVI and its pneumococcal sub-committee should be given further time to properly scrutinise the models before providing final advice. This was reflected in the minutes of both the February and June 2025 meeting minutes.

Further work on the models is ongoing, meaning JCVI advice remains outstanding on PCV20 in infants. The Department will consider any further JCVI advice on the pneumococcal vaccines used in the infant vaccination schedule in due course.

To improve the uptake across the pneumococcal programmes, vaccinations are offered all year round and general practitioners (GPs) proactively invite patients when they are eligible.

For the adult programme, this applies to those aged 65 years old and over and in the childhood programme, this applies to children aged 12 weeks, one year old and clinical risk groups at two years old and over. All parents are also actively encouraged to check their children’s vaccine records and contact their local GP if they have missed any vaccinations.

As the pneumococcal programmes are not seasonal, General practitioners contact patients throughout the year as they reach the eligible age. For the adult programme, this applies to those aged 65 year old and over and in the childhood programme, this applies to children aged 12 weeks, one year old and clinical risk groups at two years old and over.

The vaccine strategy has been delayed due to the Department’s ongoing response to the pandemic. The strategy is being kept under review given the continuously evolving understanding of COVID-19, its vaccines and vaccination programmes and the impact of these developments.

The Vaccine Strategy is being kept under review to reflect new developments from the COVID-19 vaccine and extended flu programme. Further detail on content and publication will be available in due course.

There were large reductions in pneumococcal disease since the start of the COVID-19 pandemic, most likely because of the lockdown measures that were implemented nationally. Co-infections of SARS-CoV-2 and pneumococcal disease occur very rarely. The number of pneumococcal infections and more so deaths due to pneumococcal disease in people with COVID-19 has been low. As such, it is not possible to assess the effectiveness of protection conferred by pneumococcal vaccination in reducing deaths of people who have tested positive for COVID-19.

The most recently published pneumococcal polysaccharide vaccine (PPV) coverage data are for the year 1 April 2019 to 31 March 2020. PPV coverage was 69.0% in all patients aged 65 years and over, immunised at any time up to 31 March 2020 in England, rising to 82.4% for those aged 75 years and over. The proportion immunised in the last 12 months for these two age groups was 3.8% and 1.4% respectively.

These data are available to view here:

https://www.gov.uk/government/publications/pneumococcal-polysaccharide-vaccine-ppv-vaccine-coverage-estimates

As the supply of the PPV23 vaccine is limited due to high demand, the Joint Committee on Vaccine and Immunisation is not currently planning to undertake an assessment of the potential merits of extending eligibility for the vaccine. Public Health England has issued comprehensive clinical guidance on how to prioritise those who should receive this vaccine.

There are two pneumococcal vaccines that are currently recommended for use, pneumococcal polysaccharide 23-valent vaccine (PPV23) and pneumococcal polysaccharide conjugate 13-valent vaccine PCV13 (Prevenar 13).

We are aware that, due to high demand, supplies of PPV23 are currently out of stock across the country. Further supplies are expected to become available in late January 2021. We are working closely with suppliers and the healthcare system to ensure that patients with the greatest clinical need can access the vaccine. We are continuing to liaise with the supplier to support expedited future deliveries.

There are two pneumococcal vaccines that are currently recommended for use, pneumococcal polysaccharide 23-valent vaccine (PPV23) and pneumococcal polysaccharide conjugate 13-valent vaccine PCV13 (Prevenar 13).

We are aware that, due to high demand, supplies of pneumococcal vaccine PPV23 (Pneumovax 23) are limited across the country. We are working closely with suppliers and the healthcare system to ensure that patients with the greatest clinical need can access the vaccine. We are continuing to liaise with the supplier to support expedited future deliveries. Public Health England has issued comprehensive clinical guidance which provides information on management of potentially affected patients during this time. Practitioners have been advised to prioritise PPV23 vaccinations based on clinical risk and to plan vaccinations to ensure demand is more consistent across the year. Further, on 6 November 2019, all pneumococcal vaccines were added to the list of medicines that cannot be parallel exported, further protecting United Kingdom supplies and vaccine availability.

We are not aware of any issue affecting the supply PCV13.

The Department is aware that there is currently limited availability of the pneumococcal polysaccharide vaccine (PPV23). There have been intermittent supply issues over the last 2-3 years due to manufacturing capacity constraints and an increase in global demand for the vaccine.

Public Health England has issued comprehensive guidance to the National Health Service clinicians on the management of potentially affected patients during this time of limited availability. General Practices have been advised to prioritise PPV23 vaccinations based on clinical risk and to plan vaccinations to ensure demand is more consistent across the year.

On 6 November 2019, PPV23 was added to the list of medicines that cannot be parallel exported, further protecting United Kingdom supplies and vaccine availability.

Based on our knowledge of influenza, an epidemic of viral pneumonia caused by COVID-19 infection, could potentially result in an increased risk of invasive pneumococcal disease above and beyond the normal seasonal variation. The United Kingdom pneumococcal conjugate programme in children provides strong ‘herd immunity’, which protects the whole population, including the elderly, against the 13 types contained in the vaccine. Cases due to other types of pneumococcus may also be covered by the vaccine which is offered as part of a national programme to those in clinical risk groups and to all over 65s. This vaccine covers 23 types of pneumococcus and will provide modest protection against severe forms of infection to those vaccinated. Both immunisation programmes may therefore help to mitigate any potential risk of an increase in pneumococcal infection associated with any COVID-19 epidemic.

The Department is aware that there is currently limited availability of the pneumococcal polysaccharide vaccine (PPV23), due to manufacturing capacity constraints. Further deliveries of the vaccines are due at the end of February 2020.

Public Health England has issued comprehensive guidance to the National Health Service that provides information to clinicians on the management of potentially affected patients during this time of limited availability. General practices have been advised to prioritise PPV23 vaccinations based on clinical risk and to plan vaccinations to ensure demand is more consistent across the year.

On the 6 November 2019, PPV23 was added to the list of medicines that cannot be parallel exported, further protecting United Kingdom supplies and vaccine availability.

The vaccine differs from the pneumococcal conjugate vaccine (PCV13) vaccine used for the routine childhood programme. There is no supply issue affecting the PCV13 vaccine used in infants and toddlers—but this vaccine is not suitable for protection of older people.

The modelling by Public Health England (PHE) on the estimated impact of revising the pneumococcal conjugate vaccine schedule from 2+1 to 1+1 has been accepted for publication by Public Library of Science (PLoS) Medicine and is due to be published shortly. Release of the modelling data prior to its publication could prejudice publication.

The poster Estimated impact of revising the 13-valent pneumococal conjugate vaccine schedule from 2+1 to 1+1 in England and Wales: a modelling study, presented by PHE at the European Society for Paediatric Infectious Diseases, provides context for the model on additional invasive pneumococcal disease cases, pneumococcal community acquired pneumonia cases and deaths. A copy of the poster is attached.

More detail will be available once the published paper is available.

The modelling by Public Health England (PHE) on the estimated impact of revising the pneumococcal conjugate vaccine schedule from 2+1 to 1+1 has been accepted for publication by Public Library of Science (PLoS) Medicine and is due to be published shortly. Release of the modelling data prior to its publication could prejudice publication.

The poster Estimated impact of revising the 13-valent pneumococal conjugate vaccine schedule from 2+1 to 1+1 in England and Wales: a modelling study, presented by PHE at the European Society for Paediatric Infectious Diseases, provides context for the model on additional invasive pneumococcal disease cases, pneumococcal community acquired pneumonia cases and deaths. A copy of the poster is attached.

More detail will be available once the published paper is available.

The Joint Committee on Vaccination and Immunisation (JCVI) provides independent expert advice on the United Kingdom immunisation programme. It bases its recommendations on review of a wide range of scientific and other evidence, including from the published literature, and commissioned studies such as independent analyses of vaccine effectiveness and cost effectiveness. It can consult with stakeholders on its advice when it deems this necessary.

Between January and April 2018, the JCVI undertook a focused stakeholder consultation on its proposed advice about a change to the UK’s childhood pneumococcal conjugate vaccine schedule. The JCVI is well placed to carry out stakeholder consultation to ensure the latest and most appropriate evidence has been considered on potential changes to scheduling within the vaccine programme, including identifying who to target to obtain the evidence it needs to inform its advice. It is the JCVI rather than the Government that is best placed to carry out consultation about scheduling within the vaccine programme and who to target the consultation at.

The Advance Market Commitment (AMC) for Pneumococcal Vaccines (PCV) incentivises vaccine manufacturers and generates competition by encouraging additional manufacturers to the market. So far, 114 million children have been vaccinated with AMC-supported pneumococcal vaccines, saving 762,000 lives.

The UK assess AMC to be an effective and efficient mechanism to improve vaccine coverage at a lower cost. It scored an A+ in its last annual review. In March 2019, Pfizer reduced the price of PCV for 73 developing countries from US$3.30 in 2017 to US$2.90 per dose. This further reduction is estimated to save Gavi and developing country governments up to US$ 4.1 million.

An independent 2015 evaluation identified AMC’s supply arrangements as a critical factor in encouraging vaccine manufacturers to expand their capacity to produce safe, effective vaccines. As part of the planning process for the next phase for Gavi, the UK and other stakeholders are exploring all innovative financing options which can improve global immunisation in poor countries.

The Advance Market Commitment (AMC) for Pneumococcal Vaccines is a dynamic financing instrument of Gavi, the Vaccine Alliance. Its objective is to reduce deaths from severe pneumonia by reducing the cost of the pneumococcal vaccine. The AMC does this by incentivising vaccine manufacturers and generating greater competition by encouraging additional manufacturers to the market. So far, 114 million children have been vaccinated with AMC-supported pneumococcal vaccines, saving 762,000 lives.

DFID has committed $485 million to AMC from 2010 until 2020. The AMC has consistently delivered and performs very strongly. It scored an A+ in its last Annual Review. The current end date is scheduled for December 2020. DFID are currently reviewing vaccine demand projections and in discussions with other stakeholders whether an extension is required in order to attract new manufacturers and generate wider benefits. This review is in line with our approach to maximise effectiveness and ensure good value for money.

The Advance Market Commitment (AMC) for Pneumococcal Vaccines is a dynamic financing instrument of Gavi, the Vaccine Alliance. Its objective is to reduce deaths from severe pneumonia by reducing the cost of the pneumococcal vaccine. The AMC does this by incentivising vaccine manufacturers and generating greater competition by encouraging additional manufacturers to the market. So far, 114 million children have been vaccinated with AMC-supported pneumococcal vaccines, saving 762,000 lives.

The expected total funding for DFID’s contribution to AMC is $485 million from 2010 until the programme completes in 2020. To date, the UK have made no new financial commitments for AMC beyond completion of the programme in 2020. As part of the planning process for the next phase for Gavi, the UK and other stakeholders are exploring all innovative financing options which can improve global immunisation in poor countries.

The Joint Committee on Vaccination and Immunisation (JCVI) provides independent expert advice on the United Kingdom’s immunisation programme. As an independent committee, it is well placed to ensure the latest and most appropriate evidence has been considered on potential changes to scheduling within the vaccine programme. It bases its advice on review of a wide range of scientific and other evidence, including from the published literature, commissioned studies such as independent analyses of vaccine effectiveness and cost effectiveness.

The JCVI advised that a two-dose schedule for the infant pneumococcal conjugate vaccine (PCV) Prevenar13 is appropriate for the UK. Its advice takes into account the public health aspects of any potential change to the vaccination schedule, such as the potential impact on cases of infectious disease. The JCVI consulted relevant stakeholders on its proposed advice, between January and April 2018, to ensure that its advice reflects all the evidence.

The JCVI’s advice on the infant pneumococcal programme was given full consideration, including the potential public health implications, before a decision was made to implement it. The UK frequently adopts innovative immunisation schedules and we regularly change the vaccine schedule following the advice of our independent expert committee, as we are doing in this case.

The decision is based on the excellent effectiveness of the vaccine and years of high uptake, which has helped to provide protection to the rest of the population and has successfully controlled many types of pneumococcal disease in this country. The evidence shows that two doses will sustain the excellent results we have already seen. We are confident that the world-class disease surveillance system we have in this country means our expert committee can closely monitor the impact of this change. This is set out in the JCVI’s minutes which are attached.

The Joint Committee on Vaccination and Immunisation (JCVI) provides independent expert advice on the United Kingdom’s immunisation programme. As an independent committee, it is well placed to ensure the latest and most appropriate evidence has been considered on potential changes to scheduling within the vaccine programme. It bases its advice on review of a wide range of scientific and other evidence, including from the published literature, commissioned studies such as independent analyses of vaccine effectiveness and cost effectiveness.

The JCVI advised that a two-dose schedule for the infant pneumococcal conjugate vaccine (PCV) Prevenar13 is appropriate for the UK. Its advice takes into account the public health aspects of any potential change to the vaccination schedule, such as the potential impact on cases of infectious disease. The JCVI consulted relevant stakeholders on its proposed advice, between January and April 2018, to ensure that its advice reflects all the evidence.

The JCVI’s advice on the infant pneumococcal programme was given full consideration, including the potential public health implications, before a decision was made to implement it. The UK frequently adopts innovative immunisation schedules and we regularly change the vaccine schedule following the advice of our independent expert committee, as we are doing in this case.

The decision is based on the excellent effectiveness of the vaccine and years of high uptake, which has helped to provide protection to the rest of the population and has successfully controlled many types of pneumococcal disease in this country. The evidence shows that two doses will sustain the excellent results we have already seen. We are confident that the world-class disease surveillance system we have in this country means our expert committee can closely monitor the impact of this change. This is set out in the JCVI’s minutes which are attached.