India accounts for a disproportionately high fraction of the global pneumococcal disease burden compared with its population size, mostly due to subnational regions of very high rates of disease compared with other states in the country and other countries in the world.

The Indian Network for Streptococcus pneumoniae and PCV Impact Research (INSPIRE) Project is a partnership led by the Johns Hopkins Bloomberg School of Public Health International Vaccine Access Center (IVAC), in collaboration with the International Clinical Epidemiology Network (INCLEN) and is designed to evaluate the impact of PCV introduction in the Indian Universal Immunization Program (UIP). The health economics part of this study aims to generate new evidence on the economic burden of hospitalized pneumonia and invasive pneumococcal disease in India. The study will estimate the cost of illness from the health care system and household perspectives and estimate the catastrophic impact on households through primary data collection. We are collecting data on health facility expenditures and utilization of health services for treating hospitalized pneumonia and invasive pneumococcal disease from facility administrators, medical and non-medical staff, and laboratory technicians. We are also collecting out-of-pocket expenditures, productivity loss, and household impact data from children hospitalized with clinical pneumonia and laboratory confirmed invasive pneumococcal disease at three hospitals using a facility-based cohort study design. This study is being conducted at two government hospitals in Delhi and Jaipur and one private hospital in Bareilly. Results from this study will be used to support policy decisions on PCV vaccine introduction and accelerated roll-out in India.

This study is embedded in a larger PCV impact study being conducted at 7 hospital sites and 2 community sites in northern India. The goal of the larger INSPIRE study is to generate evidence for policy makers on changes in pneumococcal disease burden in young children and pneumococcal community transmission changes as a result of PCV introduction, that can help policy makers support, optimize, and advocate for the expansion of the PCV immunization program in India and in other countries.

PI Mentor: Cristina Garcia