Last updated: 1 September 2025

Terms of Reference

Full Terms of Reference in PDF format

To provide advice to SAGE on use of pneumococcal conjugate vaccines in national programmes to vaccinate children, the Working Group will:

•  Review new data on schedule optimization in childhood, including efficacy/effectiveness, cost, and feasibility data related to 3+0, 2+1 and 1+1 schedules;
• Identify potential gaps in evidence and additional research needs for a decision on a universal two dose recommendation;
• Review efficacy, effectiveness, cost, and modeling data related to a potential recommendation for multi-age cohort PCV campaigns in response to outbreaks, in humanitarian settings, or in areas where uptake is very low;
• Review available data and timelines to licensure/prequalification for newer PCV products with pediatric indication. 
• Review data on fractional dose PCV use studies for a potential recommendation on this a strategy in the setting of vaccine supply constraints.

Composition

SAGE Members

• Anthony Scott, KEMRI-Wellcome Trust Research Programme, Kenya (Chair of the Working Group)
• Cristiana Toscano: Federal University of Goiás, Brazil

Experts

• Narendra Arora: The INCLEN Trust International, New Delhi
• Stefan Flasche: London School of Hygiene & Tropical Medicine, United Kingdom
• David Goldblatt: University College London, United Kingdom
• Elisabeth Lieke Sanders: National Institute for Public Health and the Environment, The Netherlands
• Dafrossa Lymo: Ministry of Health, Tanzania
• Elizabeth Miller: London School of Hygiene & Tropical Medicine, UK
• Betuel Sigauque: Manhiça Health Research Centre, Mozambique

  WHO Secretariat

• Daniel Feikin

Declaration of interests

All Working Group members completed a declaration of interests. Four current member reported relevant interests related to the terms of reference of the Working Group. Anthony Scott will recuse himself from the recommendation-making regarding fractional dose PCV use. It was assessed that the remaining members could fully participate in all proceedings of the Working Group. 

The reported relevant interests are summarized below:

Anthony Scott

• Serves as a DSMB member on the PATH Vaccine Solutions PNEUMOSIL clinical development vaccine trial in The Gambia. This interest was perceived as non-personal, specific, and financially insignificant.
• Serves on the UK Joint Committee on Vaccination and Immunisation (JCVI) Subcommittee. This interest was perceived as personal, non-specific, and financially insignificant.
• His institution receives funding from the Bill and Melinda Gates Foundation (BMGF) and he serves as principal investigator on a fractional dose pneumococcal conjugate vaccine trial. This interest was perceived as non-personal, specific, and financially significant.
• His institution received funding until 2019 from Gavi and he serves as principal investigator on a PCV post-licensure study of PCV10 impact in Kenya. This interest was perceived as non-personal, specific, and financially significant.
• His institution receives funding from Wellcome Trust on a research grant on using pneumococcal carriage to inform PCV policy in Africa. This interest was perceived as non-personal, non-specific, and financially significant.

Cristiana Toscano

• Serves on the PAHO TAG. This interest was perceived as personal, non-specific and financially insignificant*.
• Her institution receives funding from PAHO to provide technical support to research Project on PCV Impact in Latin America. This interest was perceived as non-personal, non-specific and financially significant*.
• Her institution receives funding from RD4 to support to Lusophone speaking countries transitioning from GAVI support participating in the LNCT, on capacity building activities supported by GAVI. This interest was perceived as non-personal, non-specific and financially significant*.

David Goldblatt

• Serves on the UK JCVI Subcommittee. This interest was perceived as personal, non-specific, and financially insignificant.
• His institution receives funding from BMGF and he serves as a co-investigator on a fractional dose pneumococcal conjugate vaccine trial. This interest was perceived as non-personal, specific, and financially significant.

* According to WHO's Guidelines for Declaration of Interests (WHO expert), an interest is considered "personal" if it generates financial or non-financial gain to the expert, such as consulting income or a patent. "Specificity" states whether the declared interest is a subject matter of the meeting or work to be undertaken. An interest has "financial significance" if the honoraria, consultancy fee or other received funding, including those received by expert's organization, from any single vaccine manufacturer or other vaccine-related company exceeds 5,000 USD in a calendar year. Likewise, a shareholding in any one vaccine manufacturer or other vaccine-related company in excess of 1,000 USD would also constitute a “significant shareholding”. Funding going to the expert’s research unit needs to be declared.