The scope for pneumococcal vaccines that do not prevent transmission.

The pneumococcal vaccine pipeline holds candidates developed with the aim to prevent the majority if not all pneumococcal disease. Herd protection is a critical component of the overall impact of current pneumococcal conjugate vaccines (PCVs) and is a prerequisite for disease elimination through an infant vaccination programme. We assessed the scope of a hypothetical pneumococcal vaccine candidate (HPVC) with high clinical efficacy against all pneumococci but that fails to induce such indirect protection. We found that, despite a lack of impact on unvaccinated individuals, HPVC use in infancy may offer similar or superior impact among young children if compared to current PCVs. Hence, it could provide a more affordable alternative to PCVs in particular in settings where most pneumococcal disease is concentrated in children.