The cost-effectiveness of using pneumococcal conjugate vaccine (PCV13) versus pneumococcal polysaccharide vaccine (PPSV23), in South African adults

Feldman, Charles; Dlamini, Sipho; Madhi, Shabir A.; Meiring, Susan; Gottberg, Anne von; Beer, Janetta Catharina de; Necker, Margreet de; Stander, Marthinus

doi:10.1371/journal.pone.0227945

Cited by 10 publications

(10 citation statements)

References 47 publications

(73 reference statements)

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“…Adult and at-risk pneumococcal and influenza vaccination data were obtained from [ 5 ] and: Andorra [ 108 ]; Argentina [ 109 , 110 ]; Belgium [ 111 ]; Brazil [ 112 ]; Central and Eastern Europe [ 113 ]; Denmark [ 114 , 115 ]; European nations [ 85 , 116 , 117 , 118 , 119 ]; Europe and Gulf nations [ 120 ]; Germany [ 121 ]; Gulf nations [ 122 , 123 ]; Hong Kong [ 124 ]; Hungary [ 125 ]; Iceland [ 126 ]; Ireland [ 127 ]; Israel [ 128 ]; Latin America [ 129 ]; Mexico [ 130 , 131 ]; New Zealand [ 132 ]; Poland [ 133 ]; Qatar [ 134 ]; San Marino [ 135 ]; Singapore [ 136 ]; Slovenia [ 137 ]; South Africa [ 138 ]; Sweden [ 139 ]; Switzerland [ 140 , 141 , 142 ]; Taiwan [ 143 , 144 , 145 ]; Turkey [ 146 , 147 , 148 ]; and U.K. [ 149 ]. All of these data are summarized in Table 1 .…”

Section: Methodsmentioning

confidence: 99%

Pneumococcal and Influenza Vaccination Rates and Pneumococcal Invasive Disease Rates Set Geographical and Ethnic Population Susceptibility to Serious COVID-19 Cases and Deaths

Root‐Bernstein

2021

Vaccines

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This study examines the relationship of pneumococcal vaccination rates, influenza, measles-mumps-rubella (MMR) diphtheria-tetanus-pertussis vaccinations (DTP), polio, Haemophilus influenzae type B (Hib), and Bacillus Calmette–Guerin (tuberculosis) vaccination rates to COVID-19 case and death rates for 51 nations that have high rates of COVID-19 testing and for which nearly complete childhood, at-risk adult and elderly pneumococcal vaccination data were available. The study is unique in a large number of nations examined, the range of vaccine controls, in testing effects of combinations of vaccinations, and in examining the relationship of COVID-19 and vaccination rates to invasive pneumococcal disease (IPD). Analysis of Italian regions and the states of the United States were also performed. Significant positive correlations were found between IPD (but not lower respiratory infections) and COVID-19 rates, while significant negative correlations were found between pneumococcal vaccination and COVID-19 rates. Influenza and MMR vaccination rates were negatively correlated with lower respiratory infection (LRI) rates and may synergize with pneumococcal vaccination rates to protect against COVID-19. Pneumococcal and influenza vaccination rates were independent of other vaccination rates. These results suggest that endemic rates of bacterial pneumonias, for which pneumococci are a sentinel, may set regional and national susceptibility to severe COVID-19 disease and death.

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Section: Methodsmentioning

confidence: 99%

Pneumococcal and Influenza Vaccination Rates and Pneumococcal Invasive Disease Rates Set Geographical and Ethnic Population Susceptibility to Serious COVID-19 Cases and Deaths

Root‐Bernstein

2021

Vaccines

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“…Earlier studies, before the full impact of PCV13 on non-bacteremic pneumococcal pneumonia, or the magnitude of PCV13-associated indirect herd effects were known, indicated, respectively, that adding PCV13 to adult pneumococcal vaccination was favored compared with PPSV23 [ 52 ], and that cost-effectiveness of PCV13 in adults aged 50 years and older was comparable to other vaccine interventions [ 53 ]. Other studies, including one in a population in which a significant number of adults had pre-existing HIV infection, showed PCV13 to be cost-effective compared with PPSV23, both in the population as a whole and in particular in the HIV-infected population [ 54 ]. It seems highly unlikely that PCV13 followed by PPSV23 will be cost effective in countries where PCV13 has been used widely in infants and young children, since these strains have largely disappeared from the adult population.…”

Section: Introductionmentioning

confidence: 99%

“…These findings strengthen the case for continuing intensive vaccination programs in this population. A cost-effectiveness study comparing PCV13 and PPSV23 vaccines in South African adults, indicated that both in the public and private sectors, adult vaccination with PCV13 was cost-effective compared with PPSV23, in the whole population and especially those persons living with HIV infection [ 54 ]. In this context, some studies have confirmed immunological evidence for benefit of pneumococcal vaccination with PCV13 followed by PPSV23 versus PPSV23 alone in HIV-infected adults [ 67 ], but observations were confined to 8 weeks post-vaccination.…”

Section: Introductionmentioning

confidence: 99%

The remarkable history of pneumococcal vaccination: an ongoing challenge

2022

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Although it varies with age and geographical distribution, the global burden of infection with Streptococcus pneumoniae (pneumococcus) remains considerable. The elderly, and younger adults with comorbid conditions, are at particularly high risk of pneumococcal infection, and this risk will increase as the population ages. Vaccination should be the backbone of our current strategies to deal with this infection.Main body: This manuscript reviews the history of the development of pneumococcal vaccines, and the impact of different vaccines and vaccination strategies over the past 111 years. It documents the early years of vaccine development in the gold mines of South Africa, when vaccination with killed pneumococci was shown to be effective, even before the recognition that different pneumococci were antigenically distinct. The development of type-specific vaccines, still with whole killed pneumococci, showed a high degree of efficacy. The identification of the importance of the pneumococcal capsule heralded the era of vaccination with capsular polysaccharides, although with the advent of penicillin, interest in pneumococcal vaccine development waned. The efforts of Austrian and his colleagues, who documented that despite penicillin therapy, patients still died from pneumococcal infection in the first 96 h, ultimately led to the licensing first of a 14-valent pneumococcal polysaccharide in 1977 followed by the 23-valent pneumococcal polysaccharide in 1983. The principal problem with these, as with other polysaccharide vaccines, was that that they failed to immunize infants and toddlers, who were at highest risk for pneumococcal disease. This was overcome by chemical linking or conjugation of the polysaccharide molecules to an immunogenic carrier protein. Thus began the era of pneumococcal conjugate vaccine (PCV), starting with PCV7, progressing to PCV10 and PCV13, and, most recently, PCV15 and PCV20. However, these vaccines remain serotype specific, posing the challenge of new serotypes replacing vaccine types. Current research addresses serotype-independent vaccines which, so far, has been a challenging and elusive endeavor.Conclusion: While there has been enormous progress in the development of pneumococcal vaccines during the past century, attempts to develop a vaccine that will retain its efficacy for most pneumococcal serotypes are ongoing.

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“…With regard to the indirect benefits of PCV13 vaccination, it has been demonstrated that childhood vaccination against pneumococcal disease with the conjugate vaccine has resulted, in many countries, in a substantial reduction in disease in older adults via herd protection, due to reduced nasal carriage; however, in South Africa, despite some herd protection, the impact on the age group >65 years has been limited, as mentioned in the introduction (10,(136)(137)(138). In countries, such as the US, a maximal indirect benefit to older adults from vaccinating children has been reached that is not enhanced by subsequent direct vaccination with PCV13 in older adults, despite reasonable uptake (42).…”

Section: Pneumococcal Vaccination Recommendations For Adults 65 Years...mentioning

confidence: 99%

A comprehensive overview of pneumococcal vaccination recommendations for adults in South Africa, 2022

Feldman¹,

Dlamini²,

Richards³

et al. 2022

J Thorac Dis

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Pneumococcal infections remain a common global cause of significant morbidity and mortality.The first recommendations for adult pneumococcal vaccination, published in South Africa in 1999, contained information only on the 23-valent polysaccharide vaccine (PPV23). With the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) for use in adults and the perceived uncertainty that most clinicians had regarding use of these vaccines in adults, these vaccine recommendations were updated in 2022. A Working Group, which consisted of individuals in various fields of medical practice in South Africa, who were from different areas of the country, and included clinicians from both the public and private sectors, was assembled to revise the recommendations. The expertise of the participants varied widely, dependent on their training and specialty, and encompassed different organ systems, disease conditions, and/or practice types. Each participant was allocated a different section, based on their expertise, for which they were required to do an extensive review of the current literature and write their section. The entire working group then reviewed the complete document several times, following additional comments and recommendations. This update contains recommendations for the use of both PPV23 and PCV13, either alone, or in sequence, both in vaccine naïve and in previously vaccinated individuals. It includes both age and risk categories, and encompasses the elderly (≥65 years), as well as younger adults (<65 years

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The cost-effectiveness of using pneumococcal conjugate vaccine (PCV13) versus pneumococcal polysaccharide vaccine (PPSV23), in South African adults

Cited by 10 publications

References 47 publications

Pneumococcal and Influenza Vaccination Rates and Pneumococcal Invasive Disease Rates Set Geographical and Ethnic Population Susceptibility to Serious COVID-19 Cases and Deaths

Pneumococcal and Influenza Vaccination Rates and Pneumococcal Invasive Disease Rates Set Geographical and Ethnic Population Susceptibility to Serious COVID-19 Cases and Deaths

The remarkable history of pneumococcal vaccination: an ongoing challenge

A comprehensive overview of pneumococcal vaccination recommendations for adults in South Africa, 2022

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