Evolving Challenges in Combating Invasive Pneumococcal Disease in the Gulf Region

Invasive pneumococcal disease (IPD), caused by Streptococcus pneumoniae, remains a major public health concern across the Gulf Cooperation Council (GCC) nations, disproportionately affecting vulnerable groups such as young children and individuals with chronic illnesses. A narrative review summarizing data from Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE) highlights the varied epidemiology, the continued disease burden, and the need for updated vaccination strategies.

While the introduction of Pneumococcal Conjugate Vaccines (PCVs), such as PCV13, has successfully reduced the incidence of vaccine-covered serotypes across the region, two main challenges threaten to reverse this progress. First, there is a notable variability and emergence of non-PCV13 serotypes (Non-Vaccine Serotypes, or NVTs), including types 8, 15B, 22F, and 33F, which are becoming increasingly prominent. Serotype coverage for PCV13 varies significantly, from a low of 37.1% in Oman to a high of 78.26% for children under two in Qatar. Second, Antimicrobial Resistance (AMR) is on the rise, with Multi-Drug Resistant (MDR) strains becoming more common, especially in the UAE and Kuwait. Additionally, mass gatherings, like the Hajj pilgrimage, exacerbate the spread of these resistant strains.

The disease burden remains highest in children under two years of age. Gaps in vaccine coverage, as seen in Kuwait and Saudi Arabia, alongside socioeconomic factors such as limited healthcare access for expatriate populations, further complicate control efforts.

To mitigate the IPD burden, the review emphasizes the urgent need for enhanced public health interventions. This includes strengthening surveillance systems to track evolving serotype distribution and AMR trends, expanding local research, and optimizing vaccination strategies. The emergence of NVTs and MDR strains suggests a transition to higher-valency vaccines, such as PCV20, could offer a more comprehensive and effective long-term solution for the GCC region.

Reference Source
Mokaddas E, Al-Jardani AK, Saeed NK, Doiphode S, Senok A, Joury J, Egaila M (2025) Invasive pneumococcal disease in the Gulf region: a narrative review of incidence, burden, and vaccine strategies.
Frontiers in Public Health 13:1589366. doi: 10.3389/fpubh.2025.1589366.