BACKGROUNDS: In the Netherlands, the 10-valent pneumococcal conjugate vaccine (PCV10) has been on the infant national immunization program (NIP) since 2011. After ten years of implementation, PCV10 only covers 2% of remaining invasive pneumococcal disease (IPD) in children <5 years. Whereas the 13- valent (PCV13) covers 27% of remaining IPD and would provide broader coverage. Higher-valent PCVs, a 15-valent (PCV15) and a 20-valent (PCV20), may soon be available in 2024 and cover more disease burden. The objective is to determine the public health impact of switching the PCV10 NIP to (1) PCV13 in the near-term (2021-2023) and (2) PCV15 or PCV20 in the long-term (2024-2028).
METHODS: A decision-analytic model was adapted to estimate IPD, hospitalized and non-hospitalized pneumonia, otitis media (OM) cases and deaths. The model utilized historical age-stratified real-world data to estimate future disease. IPD incidence reductions for newly covered serotypes were projected for PCV13, PCV15, and PCV20 by using the annual percent reductions in PCV13-10 type IPD from a systematic review. OM and pneumonia incidence are assumed to vary proportionately with IPD.
RESULTS: Switching to PCV13 in 2021 is estimated to prevent 701 IPD, 3,699 OM, 10,666 nonhospitalized pneumonia, and 1,444 hospitalized pneumonia cases, and 209 deaths over 3 years (Figure 1). Compared with switching to PCV15 in 2024, switching to PCV13 in 2021 and PCV20 in 2024 is estimated to prevent a total of 26,542 cases and 895 deaths over 8 years.
CONCLUSIONS/LEARNING POINTS: Compared to maintaining PCV10, switching to PCV13 can reduce disease burden in the near-term. However, switching to PCV13 in 2021 and PCV20 in 2024 is estimated to provide the greatest public health impact in the near- and long-term by protecting against serotypes that are not currently covered.
