A vaccine that protects against bacterial infections that can cause life-threatening meningitis, pneumonia or sepsis will be available free for children across India through the universal immunisation programme.

The Union health ministry on Friday launched the nationwide expansion of the pneumococcal conjugate vaccine (PCV), four years after introducing it in five states: Bihar, Gujarat, Himachal Pradesh, Madhya Pradesh and Uttar Pradesh.

While PCVs have been available across India since 2008 through private paediatricians for those willing to pay for the jabs, the health ministry introduced the vaccine for free in the five states in 2017 with support from GAVI, a global vaccine alliance funded by multiple countries and institutions.

A disease burden assessment exercise had in 2015 estimated that around 560,000 episodes of severe pneumonia and 105,000 pneumonia deaths caused by the bacteria Streptococcus pneumoniae had occurred among children under five in India in 2010.

Another burden assessment exercise in 2020 had estimated that pneumococcal pneumonia had caused 192,000 child deaths in India during 2015.

Sections of public health experts have for years urged the nationwide expansion of PCV, arguing that severe pneumonia frequently requires hospitalisation and adds to the financial burden of households and the public healthcare resources.

“For the first time in the country, PCV will be available for universal use,” health minister Mansukh Mandaviya said at Friday’s launch programme.

The nationwide rollout of PCV is expected to significantly reduce child mortality, he said.

Despite steady reductions in India’s child mortality rates, the 2015 exercise had estimated that 14 per cent of deaths among children below five years of age had occurred due to pneumococcal infections.

Although PCVs have been available through the private sector across the country for over 13 years, paediatricians and public health researchers say the vaccine’s uptake has been significantly below expectations even across affluent households.

One study published in 2016 had estimated that overall PCV coverage for children through the private sector in several states across the country ranged between 0.07 per cent and 2.38 per cent. PCV coverage was relatively higher in large cities — 13 per cent in Mumbai, 4 per cent in Chennai and 2 per cent in Delhi and Calcutta — but still below the expected levels for private sector sales.

In the private sector, the vaccine — which has to be given in three doses — has been available at prices ranging from around Rs 1,200 to over Rs 3,000 per dose.

Health researchers had estimated earlier this year that the nationwide introduction of PCVs would cost $227 million (Rs 1,700 crore) to cover the 26 million newborns annually, if the vaccine is available at $3.1 (Rs 232) per dose.

“Although expensive, the vaccines are expected to have a large benefit”, given the country’s high burden of pneumococcus pneumonia deaths, a seven-member team of researchers had said last month in a research report on public finances required for the universal immunisation programme.

The researchers from multiple academic institutions in India and the US had also estimated the national cost of providing basic vaccination services in 2020 was about $784 million (Rs 5,881 crore).