Ten year public health impact of 13-valent pneumococcal conjugate vaccination in infants: A modelling analysis

Sutton, Kelly; Dillon-Murphy, Desmond; Patel, Shreeya; Hilton, Betsy; Farkouh, Ray; Wasserman, Matt

doi:10.1016/j.vaccine.2020.08.068

Cited by 26 publications

(45 citation statements)

References 39 publications

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“…For every two children vaccinated, approximately one case of pneumococcal disease has been averted in Australia. The patient outcome results from this analysis are consistent with evaluations estimating the impact of PCV programs around the world [25]. In contrast, several studies have shown PCV programs provide a positive net return on investment and were evaluated as being cost saving [12,13].…”

Section: Discussionsupporting

confidence: 79%

Retrospective Impact Analysis and Cost-Effectiveness of the Pneumococcal Conjugate Vaccine Infant Program in Australia

et al. 2021

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Australia introduced the 7-valent pneumococcal conjugate vaccine (7vPCV) on the universal infant National Immunisation Program (NIP) in 2005 and replaced it with the 13-valent pneumococcal conjugate vaccine (13vPCV) in 2011, both under a 3 ? 0 schedule. The objective of this analysis was to quantify the clinical and economic impact of the universal infant PCV program in Australia from its introduction. A decision-analytic model was developed to estimate the historical impact of pneumococcal conjugate vaccine (PCV) programs in Australia from a direct health care perspective. Historical incidence of invasive pneumococcal disease (IPD), pneumonia, and otitis media (OM) were obtained from available Australian epidemiologic databases supplemented with published data. Costs were from Medicare Benefits Schedule in 2018 Australian dollars and utility weights from published sources. Historical observed changes in disease for the universal PCV NIP era (2005-2017) were compared against a ''no-vaccine'' scenario. The expected incidence for the no-vaccine scenario in years 2005-2017 was calculated using pre-universal PCV NIP era (2001-2004) data. Averted cases, deaths, incremental costs, and quality-adjusted life years (QALYs) were obtained by subtracting the vaccine scenario totals from the no-vaccine scenario totals. From the inclusion in the universal infant NIP, 7vPCV and 13vPCV are estimated to have prevented 1,770,024 cases of pneumococcal disease (IPD = 16,392; OM = 1,575,491; pneumonia = 102,059) and 1195 associated deaths. Over this period, there was a total 24,335 QALYs gained. Costs for the universal infant NIP were offset by $733 million direct costs saved, resulting in an incremental cost-effectiveness ratio of $3347 per QALY gained. PCVs have provided substantial public health and economic value from sustained use in Australia. Results are conservative, since long-term pneumococcal disease consequences and broader socioeconomic benefits were not considered. Maintaining 13vPCV on the Australian infant NIP under the newly implemented 2 ? 1 schedule will likely provide more return on investment and sustained reductions in pneumococcal disease.

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Section: Discussionsupporting

confidence: 79%

Retrospective Impact Analysis and Cost-Effectiveness of the Pneumococcal Conjugate Vaccine Infant Program in Australia

et al. 2021

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“…We conducted a literature review to identify and synthesize published data on all pneumococcal diseases during the past 20 years. We used data from these publications to model the effects of PCVs on childhood pneumococcal disease ( 13 ).…”

Section: Methodsmentioning

confidence: 99%

Twenty-Year Public Health Impact of 7- and 13-Valent Pneumococcal Conjugate Vaccines in US Children

Wasserman¹,

Lapidot²,

Sutton³

et al. 2021

Emerg. Infect. Dis.

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B efore 2000, children <2 years of age had the highest incidence of invasive pneumococcal diseases (IPDs) such as bacteremia, meningitis, or other infection of a normally sterile site (1). Researchers estimated that, in the United States, annual IPD incidence was 165 cases/100,000 children <12 months of age and 203 cases/100,000 children 12-23 months of age (1). Until the United States began a universal 7-valent pneumococcal conjugate vaccine (PCV7) immunization program for children in 2000, Streptococcus pneumoniae was the leading cause of bacterial meningitis (1).S. pneumoniae was also the most common bacterial cause of community-acquired pneumonia and otitis media (OM) in young children. Furthermore, in the 1990s, concerns emerged regarding the growing number of pneumococcal isolates with reduced susceptibility to fi rst-and second-line antimicrobial drugs (1).PCV7 was the fi rst pneumococcal conjugate vaccine (PCV) approved for use in children <2 years of age in the United States. Pneumococcal polysaccharide vaccines, which preceded PCVs, are not immunogenic in children <2 years of age (1,2). PCV7 overcame the challenge of poor immunogenicity among infants and young children through conjugation technology; it was introduced into the US infant immunization schedule in 2000, providing direct protection against several serotypes of invasive and noninvasive pneumococcal disease (3,4). PCV7 protects against the S. pneumoniae serotypes responsible for >80% of IPD cases among children in North America (i.e., serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F) (1,4). In 2010, PCV13, a vaccine providing protection against 6 additional serotypes (i.e., serotypes 1, 3, 5, 6A, 19A, and 7F), was approved in the United States, partially because of increasing incidence of serotypes not covered by PCV7 (1,4).Clinical trial data suggested that PCV7 would be effective against IPD, OM, and according to a posthoc analysis, pneumonia (5). The effi cacy of PCV7 (and later PCV13) against all forms of pneumococcal disease was greater than expected, partly because of indirect protection gained through herd immunity (6-8). The United States was the fi rst country to introduce a PCV program for infants and, during the transition to PCV13, recommended the largest catchup program for children <5 years of age who had been vaccinated with PCV7 (9). After an initially slow uptake limited by constrained supply, the United States has achieved consistently high (>80%) 3-dose

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“…In 2009, two higher valent PCVs were licensed for use around the world, a 10-valent vaccine (PCV10-GSK; Synflorix TM , GlaxoSmithKline) containing the PCV7 serotypes plus serotypes 1, 5, and 7F, and a 13-valent vaccine (PCV13-PFE; Prevenar13 TM , Pfizer), containing PCV10-GSK serotypes plus serotypes 3, 6A, and 19A. Over the last 10 years, PCV10-GSK and PCV13-PFE have demonstrated a substantial public health impact in reducing pneumococcal disease globally [7][8][9]. As a result of routine PCV infant immunization in many countries, pneumococcal deaths among children younger than 5 years old decreased between 2000 and 2015 by 51% worldwide [3].…”

Section: Introductionmentioning

confidence: 99%

Estimating the Public Health and Economic Impact of Introducing the 13-Valent Pneumococcal Conjugate Vaccine or 10-Valent Pneumococcal Conjugate Vaccines into State Immunization Programs in India

et al. 2021

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Introduction: Although the pneumococcal conjugate vaccine (PCV) has been introduced into select state immunization programs (SIPs) in India, many children remain unvaccinated. Recently, India's Advisory Committee on Vaccines & Immunization Practices recommended PCV on the pediatric immunization schedule nationally. This study estimates the public health and economic impact of introducing either Pfizer's 13-valent PCV (PCV13-PFE), GlaxoSmithKline's 10-valent PCV (PCV10-GSK), or Serum Institute of India's 10-valent PCV (PCV10-SII) into every pediatric SIP. Methods: A model was developed to predict the disease cases, deaths, and costs associated with implementing PCV13-PFE, PCV10-GSK, or PCV10-SII in SIPs compared to no vaccination program across a 5-year period (2021-2025). State and national-level uptake rate and clinical and economic input parameters were collected from published literature. Disease outcomes included invasive pneumococcal disease, inpatient and outpatient pneumonia, and otitis media. Costs were estimated as vaccine-related costs and direct medical costs incurred to the healthcare system. Results were reported by individual state and aggregated nationally. Results: Estimated over 5 years, implementing PCV13-PFE in SIPs could avert 12.1 million cases and save 626,512 lives among children under 5 years old compared to no vaccination. This corresponds to net national cost savings of over $1.0 billion. Both lower-valent PCVs are estimated to provide less economic savings than PCV13-PFE inclusive of vaccine-related costs. Compared with PCV13-PFE, implementing PCV10-GSK or PCV10-SII nationally is estimated to have a smaller public health impact, with PCV10-GSK averting 8.4 million cases (436,577 deaths) and PCV10-SII preventing 10.3 million cases (531,545 deaths) in India compared to no vaccination, respectively.

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Ten year public health impact of 13-valent pneumococcal conjugate vaccination in infants: A modelling analysis

Cited by 26 publications

References 39 publications

Retrospective Impact Analysis and Cost-Effectiveness of the Pneumococcal Conjugate Vaccine Infant Program in Australia

Retrospective Impact Analysis and Cost-Effectiveness of the Pneumococcal Conjugate Vaccine Infant Program in Australia

Twenty-Year Public Health Impact of 7- and 13-Valent Pneumococcal Conjugate Vaccines in US Children

Estimating the Public Health and Economic Impact of Introducing the 13-Valent Pneumococcal Conjugate Vaccine or 10-Valent Pneumococcal Conjugate Vaccines into State Immunization Programs in India

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