INTRODUCTION:Maternal immunization (MI) has evolved over the past decade, protecting both mother and offspring from infectious diseases. In India, only one vaccine, tetanus toxoid (TT)/ tetanus and diphtheria (Td), is available under the Universal Immunization Programme (UIP) for pregnant women. However, the basket of MI can be expanded by introducing additional maternal vaccines such as the Respiratory Syncytial Virus (RSV) vaccine in the immunization schedule. Therefore, the study aims to explore the potential predictors for the uptake of the RSV vaccine under UIP. METHODOLOGY:For the study, relevant data was extracted from the National Family Health Survey (NFHS-5) conducted during 2019-21. A cross-sectional sample of women aged 15-49 years who had given birth in the past 5 years was analyzed. Bivariate statistics and logistic regression analysis were employed to assess the predictors for pregnant women's interaction with healthcare workers (HCWs) during 3rd trimester of pregnancy using Stata 17 software. This measure was used as a proxy to gauge the existing maternal health delivery platform for new vaccine introductions, like RSV, administered during the third trimester. RESULTS:Information from 174,483 women was included in the study. Of them, 59.3 % went for four or more antenatal care (ANC) visits, and a significant proportion (83.8 %) received tetanus injections. The number of antenatal care visits and tetanus injections during pregnancy emerged as strong predictors, with higher ANC visit frequencies with increased odds of meeting with healthcare workers (HCWs) during the third trimester of pregnancy. Further, younger age (20-24 years), middle wealth index group, and residence in rural areas were identified as positive predictors while higher levels of education emerged as a negative predictor. CONCLUSION:The study highlights the importance of ANC visits and tetanus vaccine uptake in engaging pregnant women with HCWs during the third trimester. These factors indicate readiness for potential interventions and suggest leveraging ANC visits for introducing RSV, a new maternal immunization vaccine.

Background: Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infections in children younger than 5 years of age. Given the high morbidity and mortality associated with RSV in India, the introduction of a vaccine against RSV will potentially reduce the disease's burden. However, vaccine acceptance is influenced by public perception, which is shaped by information disseminated through media sources. This study aims to explore the landscape of RSV-related news coverage in India's digital media. Objective: This study aims to conduct a comprehensive content analysis to explore the landscape of RSV-related news coverage in India's digital media. Methods: Media content analysis was retrospectively conducted by a digital search for all related news pieces in the trustworthy brands of 4 trusted newspapers (Hindustan Times, The Hindu, The Indian Express, and The Times of India) and 3 news channel websites (India Today, NDTV news, and News 18), between November 1, 2022, and October 31, 2023. A total of 58 news pieces were retrieved using selected keywords, with inclusion criteria encompassing English-language news pieces with RSV-specific content. Two reviewers compiled, coded, and analyzed the content. Quantitative data were analyzed descriptively, while qualitative content analysis assessed the emotional tone and sentiment of the pieces. Results: The findings revealed significant digital media coverage on RSV infection and the potential vaccines. The majority of news pieces (53/58, 91%) discussed RSV signs and symptoms, with 64% (37/58) addressing the disease severity and 36% (21/58) highlighting its seasonal surge. However, only 5% (3/58) focused on diagnostic aids. Additionally, 41% (24/58) of news pieces discussed RSV in the context of COVID-19. Regarding the vaccine, 29% (17/58) of news pieces mentioned it, with 26% (15/58) highlighting manufacturers such as Pfizer and GlaxoSmithKline (GSK). Positive sentiment was found in 35% (20/58) of news pieces, while 43% (25/58) exhibited negative sentiment, often related to the disease burden and severity. Emotional tone analysis revealed that 74% (43/58) of news pieces contained emotional elements, with 58% (25/43) expressing negative emotions (eg, concern and anxiety), particularly about hospitalizations and deaths. In contrast, a positive tone was emulated in the frequent mentions of the RSV vaccines as safe, effective, and approved. Conclusions: The analysis revealed significant coverage of RSV-related news in India's digital media, with a focus on disease severity and hospitalizations. While positive sentiment was expressed in coverage of the RSV vaccine, negative sentiments dominated discussions on the disease burden. However, considering the limited number of news pieces, the study highlights the need for improved media coverage to raise awareness about the disease and its preventive strategies. Further research should explore the implications of the overlap between RSV and COVID-19 in media coverage and the limited focus on RSV diagnostics, with a focus on understanding how these factors impact public health outcomes.

Abstract Introduction: The Pneumococcal Conjugate Vaccine (PCV) was launched phase wise in India in 2017 and was expanded nationwide in 2021, during the peak of the COVID-19 pandemic. The pandemic restrictions resulted in the hybrid trainings (physical and virtual) for the health workforce. A number of training tools were developed for the health workers to include pre-recorded sessions from immunization experts, presentations and ministry approved Frequently Asked Questions (FAQs), along with the animated videos. As the hybrid model of training was deployed for the first time in the state of Nagaland, the present study aims to evaluate the impact of the training tools used for PCV introduction in Nagaland. Methods: Mixed-method study was conducted in two districts from Nagaland selected using random sampling. In-depth interviews and Focussed Group Discussions (FGDs) were conducted with medical officers, Auxiliary Nurse Midwife (ANMs) and Accredited social Health activist (ASHAs), to gather their experience with the training tools. Quantitative data was collected through a survey among 36 ANMs and ASHAs to evaluate the impact of training tools. Based on Kirkpatrick’s model, qualitative data was thematically analysed using NVIVO 14 software, and quantitative data was analysed using SPSS software v.21. Result: Findings highlight that 29% of the respondents had received training through virtual sessions and 5% via hybrid mode. The majority (66%) of the trainings were in person. Most health workers, particularly the ANMs, found the training materials to be informative and comprehensible. Majority of the respondents preferred in-person training. The finding also revealed the challenges of online trainings included lack of focus, network instability, limited interactions with trainers and clarification of doubts real-time. Furthermore, the videos were highly appreciated for its precise content and comprehensiveness by the respondents (69%). Most of them (87%) found the videos as a pivotal tool for skill-based learning and community sensitization. Conclusion: The study revealed that the field workers still prefer face-to-face trainings. The benefits of online trainings were also highlighted. The training tools had significant positive impacts on health workers' performance and its effectiveness on community and creating awareness among the communities. The study further makes key program-based recommendations to improve trainings in future. This included sessions with visual aids in the FAQs/leaflets, their availability in local dialects for explicitness and use of more interactive elements such as video-based tools for information dissemination.

Background: Globally, pneumonia claims the lives of about 700,000 children under the age of 5 every year. Pneumococcal conjugate vaccine (PCV) was introduced in India phase-wise, beginning in high-burden states, and the rollout was completed nationwide by 2021—representing a major initiative by the Ministry of Health and Family Welfare (MoHFW). Despite the challenges posed by the COVID-19 pandemic, the campaign succeeded in maintaining progress and achieving nationwide coverage. This narrative review highlights the significant decisions, processes, and coordinated efforts of the various stakeholders involved that led to this successful PCV rollout. Methodology: A comprehensive desk review of both published and unpublished literature relevant to pneumonia burden and the efficacy and effectiveness of PCVs, along with documentation of PCV introduction and the scale-up was carried out. Results: The documentation of the PCV journey has been broken down into four sections: pre-introduction, PCV Phase-I introduction, pan-India rapid expansion, and the period post-introduction. Since the nationwide rollout in 2021, PCV coverage in India has steadily increased, reflecting successful immunization efforts. WUENIC, which is an annual WHO, and UNICEF estimates of national immunization coverage also show a positive trend in vaccination coverage (PCV booster coverage = 25% (2021), rising to 83% (2023), aligning with the goals of the WHO and UNICEF’s Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD). Conclusions: The phased rollout was an ambitious effort by the MoHFW, which was particularly challenging given the overlap with the COVID-19 pandemic. Despite these hurdles, the MoHFW, along with strong collaboration from development partners and stakeholders, successfully navigated the complex rollout. Future studies on the role of PCVs in reducing antibiotic resistance and the economic benefits of PCV introduction could help policymakers sustain funding and prioritize vaccine procurement decisions.

Cervical cancer remains the fourth most common cancer among women globally, despite being preventable with the human papillomavirus (HPV) vaccine. However, HPV vaccine uptake remains a challenge in low- and middle-income countries (LMICs), where cervical cancer elimination faces significant delays. The present study aims to identify the social determinants impacting HPV vaccine uptake in LMICs. This systematic review and meta-analysis included studies published between 2010 and 2025, identified through PubMed, Google Scholar, and ScienceDirect. Eligible studies reported HPV vaccine uptake (initiation, completion, or both) among adolescent girls aged 9 to 19 and examined at least 1 individual- or household-level social determinant. Data were thematically synthesized, and a meta-analysis was conducted using the random-effects model, with results expressed as odds ratios (ORs), with 95% confidence intervals (CIs). Eight studies, conducted in Ethiopia, Tanzania, and Uganda, were included. Key determinants assessed included age, religion, residence, parental education, occupation, wealth index, marital status, and household factors. Meta-analyses revealed wealth index (OR = 1.34; 95% CI: 1.05-1.70; P = .02) and parental marital status (OR = 0.86; 95% CI: 0.78-0.95; P < .01) as significant predictors of HPV vaccine uptake among adolescent girls in LMICs. Other factors, such as age, residence, parental education, etc., showed inconsistent effects or no significant association, with high heterogeneity across studies limiting the generalizability of some findings. This review highlights the complex, context-specific individual and household factors influencing HPV vaccine uptake among adolescent girls in LMICs. While wealth index and parental marital status showed consistent associations, other factors varied across studies. Community-based, culturally sensitive, tailored interventions are critical to improve the vaccine uptake. Continued research with standardized mixed-methods is vital to address multilevel factors and ensure equitable HPV vaccine uptake in LMICs.

Background: Pneumococcal Conjugate Vaccine (PCV) is a costly vaccine and poor and vulnerable communities can't afford it in private sector. The Indian government introduced the Pneumococcal Conjugate Vaccine into the Universal Immunization during the peak COVID time in Maharashtra in the lockdown. This study aimed to evaluate the impact of training tools used to introduce PCV in Maharashtra, India by conducting vi training during the COVID restrictions. Methods: A mixed-methods approach was employed to assess the effectiveness of training tools and the perceptions of healthcare workers. Quantitative data was collected through structured questionnaires, and qualitative data was gathered through focus group discussions and in-depth interviews. This study was conducted in four blocks of two districts viz. Pune and Nashik in the state of Maharashtra. Results: The study found that training tools, particularly animated videos, were highly effective in conveying information and enhancing the understanding. Healthcare workers appreciated the clear content, visual appeal, and practical application of the training materials. The videos were instrumental in promoting vaccine awareness and addressing community concerns. The training tools also significantly improved the skills and confidence of healthcare workers from both districts, enabling them to effectively implement the rollout of PCV. They were able to address challenges, such as parental hesitancy and COVID-19 restrictions, and successfully mobilize the community for vaccination. Conclusion: Overall, the study highlights the importance of well-designed training programs and effective training tools particularly animated videos in ensuring the successful implementation of PCV. The findings provide valuable insights for future new vaccine introduction initiatives, emphasizing the need for development of comprehensive training packages, innovative strategies such as animated videos, use of digital tools for training and continuous evaluation.

Introduction: Maternal immunization (MI) has evolved over the past decade, protecting both mother and offspring from infectious diseases. In India, only one vaccine, tetanus toxoid (TT)/ tetanus and diphtheria (Td), is available under the Universal Immunization Programme (UIP) for pregnant women. However, the basket of MI can be expanded by introducing the additional maternal vaccines in the immunization schedule. The study aims to explore the potential predictors for the uptake of additional maternal vaccines under UIP. Methodology: For the study, relevant data was extracted from the National Family Health Survey (NFHS-5) conducted during 2019-21. A cross-sectional sample of women aged 15-49 years who had given birth in the past 5 years was analyzed. Bivariate statistics and logistic regression analysis were employed to assess the predictors for pregnant women's interaction with healthcare workers (HCWs) during 3rd trimester of pregnancy using Stata 17 software. This measure was used as a proxy to gauge readiness for new vaccine introductions, like RSV, administered during the third trimester. Results: Information from 174,483 women was included in the study. Of them, 59.3% went for four or more antenatal care (ANC) visits, and a significant proportion (83.8%) received tetanus injections. The number of antenatal visits and tetanus injections during pregnancy emerged as strong predictors, with higher ANC visit frequencies with increased odds of meeting with healthcare workers (HCWs) during the third trimester of pregnancy. Further, younger age (20-24 years), middle wealth index group, and residence in rural areas were identified as positive predictors while higher levels of education emerged as a negative predictor. Conclusion: The study highlights the importance of ANC visits and tetanus vaccine uptake in engaging pregnant women with HCWs during the third trimester. These factors indicate readiness for potential interventions, like the RSV vaccine, and suggest leveraging ANC visits for introducing new maternal immunization vaccines.

Background Human papillomavirus (HPV) is a leading cause of cervical cancer. It has a substantial impact on global public health, with low- and middle-income countries, including India, facing the highest burden. In 2022, India reported 127,526 new cases and 79,906 deaths due to cervical cancer, projected to increase by 61% by 2040. Although the National Technical Advisory Group on Immunization recommended the HPV vaccine for cervical cancer prevention, it is yet to be a part of India’s universal immunization program. Objective This study aims to examine online interest in the HPV vaccine in India from January 2010 to April 2024 using Google Trends. Methods A cross-sectional analysis of Google Trends data was performed, using the relative search volume to track interest on a scale of 0‐100. Trends were analyzed annually using 1-way ANOVA and joinpoint regression to identify significant changes in search behavior related to public health events. Statistical significance was set at P<.05. Results The average annual growth in HPV vaccine-related searches was 13.7% (95% CI 7.9%‐19.1%), with the highest relative search volume in 2024 (49.5) and the lowest in 2017 (3.38). Spikes in search interest aligned with key events like the 2018 National Technical Advisory Group on Immunization recommendation and the 2022 launch of the indigenous HPV vaccine. The results highlight online search data’s value in tracking public interest, which fluctuates in response to health policy changes or developments on social media. In India, targeted digital strategies will be vital for addressing vaccine hesitancy and increasing HPV vaccine uptake. Conclusions Google Trends data can inform public health strategies by identifying periods of high interest, aiding in the promotion of HPV vaccination in India.

Background: Pneumonia is one of the leading causes of death in under-5 children in India. The phased rollout, which began in high-burden states and was completed nationwide by 2021, was a major initiative by the Ministry of Health and Family Welfare (MoHFW). Despite challenges posed by the COVID-19 pandemic, which affected logistics and required creative solutions, the campaign succeeded in maintaining progress and achieving nationwide coverage. This narrative review highlights the significant decisions, dedication and coordinated efforts of various stakeholders involved that led to accomplishment of successful PCV rollout. Methodology: A comprehensive desk review of both published and unpublished literature relevant to the burden of pneumonia, pneumococcal pneumonia mortality in children under five, the efficacy and effectiveness of Pneumococcal Conjugate Vaccines (PCVs), and the documentation of PCV introduction and scale-up in India was carried out. Results: The documentation of PCV journey has been broken down in four sections: pre-introduction, PCV Phase I introduction, Pan India rapid expansion, and post-introduction. Since the nationwide rollout in 2021, PCV coverage in India has steadily increased reflecting successful immunization efforts. The WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) also show a positive trend in vaccination coverage, which aligns with the goals of the WHO and UNICEF’s Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD). Conclusion: The phased rollout, starting with high-burden states and completing nationwide expansion by 2021, was an ambitious effort by the Ministry of Health and Family Welfare (MoHFW), particularly challenging given the overlap with the COVID-19 pandemic. Despite these hurdles, the MoHFW, with strong collaboration from development partners and stakeholders, successfully navigated the complex rollout. This is a noteworthy achievement considering the unprecedented scale of the COVID-19 vaccination drive that was simultaneously ongoing.

Introduction: In 2023, India’s National Technical Advisory Group on Immunization (NTAGI) recommended the inclusion of typhoid conjugate vaccine (TCV) in the Universal Immunization Programme (UIP). However, introducing TCV, an additional injectable vaccine (AIV), will potentially increase the number of injections administered in a single visit to a maximum of five (if given at the 9 to 12 months touchpoint) or four (if given in the second year of life). In this context, the present study aimed to explore the perspectives of program managers, service providers, and caregivers regarding introduction of an AIV in a single visit under the UIP. Methods: A mixed-method study was undertaken wherein quantitative data was collected by telephonic surveys, and qualitative data by key informant interviews (KIIs) and focus group discussions (FGDs). Purposive sampling encompassed eight states, eight districts, eight planning units, and 32 session sites. The qualitative data were thematically analyzed manually using Excel, while the quantitative data was analyzed using STATA 17. Results: A total of 1140 telephonic surveys, 96 KIIs, and 16 FGDs were conducted. The study revealed that program managers mentioned maternal emotional reactions as a significant concern and backed AIV introduction at the 9–12 months touchpoint. Vaccinators and community mobilizers favored the 16–24 months window with combined presentations and mentioned single-dose vials as the preferred approach for vaccine delivery. Caregivers acknowledged the benefits of vaccination but expressed discomfort and fear regarding multiple injections to the child in a single visit. Caregivers expressed a preference for a combination vaccine. No preference was reported among caregivers for the introduction of AIV to the 9–12 or 16–24 months touchpoints. Conclusion: Stakeholders’ perspectives on introducing an additional injectable vaccine in a single visit under the UIP are diverse. These will be helpful in developing an effective strategy for the future introduction of AIV under UIP.

Background: Worldwide, vaccine-preventable diseases have been a significant cause of mortality in the under-5 age group. To reduce the disease burden, new vaccines are being introduced in every country's immunization programmes. For this to happen, high vaccination coverage is necessary. However, rapidly identifying the areas that fail to reach the expected coverage becomes cumbersome. During recent years, lot quality assurance sampling (LQAS) has been widely used in evaluating immunization coverage across the globe. The present study aims to pilot this approach for field monitoring of a new vaccine against routine concurrent field monitoring in one of the North-Eastern states of India. Methodology: For LQAS, a community-based cross-sectional study was undertaken among 55 children aged 0-23 months in all 5 Primary health centres (lots) of Medziphema block, Dimapur, Nagaland. The total sample size for LQAS was calculated based on alpha = 5, beta = 90 using Lemeshow and Taber-LQAS table with a target level of immunization defined as 90 % and the lower limit set to 55 %. For the concurrent field monitoring, a sample of 30 children in the same age group was selected through random sampling. Pre-designed, pre-tested questionnaire for the caregivers, scripted on a digital tool was employed with verification of immunization card and caregiver's recall. Data was analyzed using SPSS software version 25.0. Results: The study found a slight difference in the percentage of children age-appropriately vaccinated for PCV (as per the schedule) in concurrent field monitoring (93.3 %) and LQAS (90.9 %). However, no statistically significant difference was found in comparing the immunization coverage using both methodologies (p > 0.05). Conclusion: The study findings encourage that LQAS can be considered for monitoring the immunization coverage of a newly introduced vaccine. It offers the added advantage of identifying poor/low-performing pockets that require focused attention.

Background and aims: The Rotavirus vaccine (RVV) introduction is a landmark event in the history of Indian public health as for the first time a novel, low-cost indigenous vaccine was introduced in a short timeline between 2016 and 2019. As per WHO mandate, post-introduction evaluation (PIE) be conducted within 6 to 12 months of vaccine introduction to provide an understanding of the operational aspects of the program. For RVV PIE, an innovative approach to developing and deploying a digitized tool was employed. The present study aims to document the processes followed for digitizing the data collection and analysis tools. Methods: The development of the RVV-PIE digital tool was undertaken in two phases. In the first phase, conceptualization and iteration of the modified WHO PIE tool were undertaken. Questions were organized sequentially to ensure natural progression in responses. The finalized questionnaire was converted to a digital version and extensive dummy data was entered to improve automated qualitative data analysis. Phase 2 involved updating the draft tool and incorporating changes to provide a field-tested version for deployment. Results: The digital version of the tool was successfully developed. The GPS functionality of the tool allowed live tracking of data collection making the process more accountable. The tool was prepopulated with reference materials and data points for easy reference and retrieval by the evaluators. The digitization of the tool also allowed easy visualization of data through maps, charts, and graphs on a real-time user-friendly dashboard. Conclusions: The digitization of the PIE tool for RVV in India has been a great learning experience where the dire situation of an ongoing pandemic catapulted us towards a more efficient and comprehensive process innovation. The RVV PIE tool could serve as a customizable digital PIE tool for other health programs heralding an era of a more effective and proficient process of PIE.

Background: India became the first country in the WHO South-East Asia Region (SEAR) to introduce the rotavirus vaccine (RVV) in the Universal immunization programme (UIP) in 2016 with nationwide expansion by 2019. It was a landmark move to reduce the diarrheal disease burden in under-five children. To assess the implementation process of introduction of RVV, Post Introduction Evaluation (PIE) was conducted in March 2022. Methods: The evaluation was conducted across 14 states, 28 districts and 28 health facilities to obtain a nationwide geographical inclusion. Stakeholders involved in program decision-making, planning, training, vaccine delivery, logistics, and communication from all levels (National, state, district, health facility, health worker, caregiver) were interviewed using standardized data collection tool for PIE (adapted from the standard WHO PIE questionnaire) and scripted on a digital tool. Results: A total of 260 interviews were conducted. Political willingness, well-planned preparedness activities, securing vaccines timely, strong supply chain monitoring, availability of domestic RVV products, quality trainings and intense communication activities were the key factors identified for the successful RVV introduction. Key activities during the introduction included cold chain space assessment, trainings of healthcare workforce, dissemination of job aids, updation of recording & reporting formats and strengthening of AEFI surveillance. Lack of community awareness for immunization in a few areas, fear of AEFI amongst some caregivers and local issues with Alternate Vaccine Delivery (AVD) were some reported challenges in achieving high coverage for RVV. Conclusions: Overall, the nationwide roll-out of RVV was smooth and the vaccine has been well-accepted in the community. The assessment emphasizes on having a well-strategized operational and communication planning, which is very crucial for any new vaccine introduction.

Background: Estimates suggest that 78,000 children died due to rotavirus gastroenteritis annually between 2011 and 2013 in India. The north eastern state of Assam reported 38.4% pediatric diarrheal admissions testing positive for rotavirus. Rotavirus vaccine (RVV) was introduced in Assam in 2017 following which the National Family Health Survey-5 (NFHS-5) (2019) revealed low RVV coverage in Assam with wide variation between the districts. the current study was conceptualized and undertaken to capture the enablers and barriers to RVV coverage in Assam. Methods: Qualitative study conducted in 5 randomly selected districts in Assam. Participants (key informants) were recruited by purposive sampling at each level of the health system including healthcare officials, service providers and caregivers based on availability. Thirty-five in-depth interviews (IDIs) and five focus group discussions (FGDs) were conducted. Interviews were tape recorded and transcribed. Data was coded and analyzed using the thematic framework approach. Results: Findings from the qualitative data collection were collated and analyzed under 7 identified themes. Difficult terrain, limited service provider availability and no catch-up training for new recruits were some of the barriers to RVV coverage. In contrast, Information, Education & Communication (IEC) in vernacular language, RVV safety profile, development partner support and adequate RVV supply were identified as some of the enablers of RVV coverage. Conclusion: Few broad recommendations to overcome identified barriers include comprehensive inter-sectoral coordination, regular monitoring and frequent refresher training sessions. There is a need for a future study utilizing existing coverage data and larger sample size to triangulate the findings of this study.

India had decided to roll out PCV in India in 2015, but successful implementation of any new vaccine introduction mandates an enormous effort. PCV was scaled up during the COVID-19 pandemic, which posed new, unprecedented challenges in the vaccine rollout. However, India successfully expanded PCV in the country in record time across all states and Union Territories. During the pandemic, supply-side restrictions, delayed vaccine shipments, staff shortages, and restrictions in conducting training negatively affected the roll-out of PCV across the country. However, despite the ongoing pandemic, India successfully rolled out PCV across the country in 7 months. In this review, the authors have conducted a narrative review to delineate the crucial factors that helped in the successful expansion of PCV. & COPY; 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Background:Pneumonia is one of the leading causes of death in under-5 children in India. This led the Ministry of Health & Family Welfare (MoHFW) in India to decide for the nationwide roll-out of the Pneumococcal Conjugate Vaccine (PCV). However, the introduction of PCV became more complex in the face of unprecedented challenges set forth by the COVID-19 pandemic. The study aims to assess enablers and barriers to the introduction of PCV in India during the pandemic.Methodology:Qualitative research approach involving key-informant interviews from John Snow India (JSI), the lead technical agency that supported MoHFW in the PCV expansion was employed to delineate the enablers and barriers. Principle of saturation was employed to derive the sample size. Thematic analysis using inductive approach was based on the modified World Health Organization (WHO) framework for new vaccine introduction impact on the Immunization and Health Systems, using NVIVO 12 qualitative data analysis software.Results:A total of 11 key informants (4 national-level program managers and 7 state technical officers) were telephonically interviewed. The study found social acceptance, lower cost of the vaccine, and intensive communication activities as potential enablers. Other enablers for PCV introduction included a robust vaccine supply-chain system, ample cold-chain space availability, and strong political commitment, despite the ongoing second wave. Further, the identified barriers included poor physical access, insufficient social mobilization, and limited advocacy along with a stretched workforce.Conclusion:The study delineated several enablers and barriers to introducing PCV in the country during the pandemic. The existing barriers in the PCV roll-out prompted the need to address these gaps, making key program-based recommendations to improve future new vaccine introductions during the pandemic.