Pneumococcal diseases in ‘under 5 populations’ are responsible for millions of deaths annually in the developing world. Effective vaccination against pneumococcal diseases is available using vaccines but their high cost has inhibited their adoption by governments in low and middleincome countries. Resistance to adoption of these vaccines also stems from the lack of population based data pertaining to disease burden and serotype prevalence which preclude the possibility of accurate costeffective analysis and longterm impact of the vaccines in improving the health of susceptible populations. In India, the pneumococcal vaccine is set to be introduced in a phased manner in its Universal Immunization Program. The Indian experience shows that the vaccine can be adopted using justifications based upon disease burden estimates through mathematical modeling and serotype prevalence from hospital based studies especially when keeping the overarching ethical principle of protecting the lives of thousands of children in mind who cannot wait for theavailability of high quality evidence proving cost effectiveness of the vaccine. However, the replicability of such behaviour by comparatively poorer nations may be difficult which renders it necessary to correctly monitor and evaluate the impact of pneumococcal vaccine introduction in Indian populations in order to provide a roadmap for expansion of pneumococcal vaccines in other resource constrained settings of the developing world.

Keywords: Pneumococcus; Vaccines; India.