[Recommendations of the Korea Expert Committee on Immunization Practices for Pneumococcal Vaccination in Children].

Objectives: The Korea Disease Control and Prevention Agency (KDCA) identified an increasing prevalence of pneumococcal serotypes not covered by vaccines that are currently used for pediatric invasive pneumococcal disease. In response, the KDCA decided to introduce a 20-valent pneumococcal conjugate vaccine (PCV20), which offers broader serotype coverage. Methods: The Pneumococcal/Meningococcal Subcommittee and the Korea Expert Committee on Immunization Practices (KECIP) reviewed the appropriateness of introducing PCV20, focusing on disease characteristics, vaccine properties, cost-effectiveness, and vaccine acceptability. Detailed implementation guidelines were also discussed. Results: PCV20 provided broader serotype coverage than existing vaccines and demonstrated non-inferior immunogenicity for shared serotypes and superior immunogenicity for additional serotypes. Safety has been confirmed through regulatory approval and existing data. As no additional costs were anticipated, the vaccine was considered cost effective. Based on domestic and international experiences, high vaccine acceptability is expected. In healthy children and adolescents, the principle is to complete the vaccination series using the same vaccine administered at initiation. However, for patients who started with PCV13, switching to PCV15 or PCV20 is permitted. PCV20 will also be used as a booster vaccination in high-risk children, with vaccine support for high-risk groups expanding to 18 years of age. Conclusions: The KECIP made a timely decision to introduce PCV20 into the National Immunization Program for children and recommends its safe implementation in clinical settings.