This is a randomised controlled trial to determine if maternal immunisation with 23 valent pneumococcal polysaccharide vaccine (23vPPV) can reduce pneumococcal carriage and middle ear disease among Aboriginal infants at seven months of age. We aim to recruit 210 Aboriginal women aged 18-39 years who have uncomplicated pregnancies: 70 will receive 23vPPV during the third trimester of pregnancy, 70 immediately postpartum, and 70 will act as a control group, receiving 23vPPV seven months after child birth. Each subject and their infant offspring will be followed-up after vaccination and at birth, one, two and seven months of age.

Our study has the potential to show clinically significant benefits in the early life of high-risk infants. The additional ear, health and immunisation status assessments offered by this research program are also likely to benefit all participants. This is an affordable vaccine for families and if effective is likely to be a good option for mothers and infants at high risk and could lead to changes to policy related to the use of the vaccine.

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