Public health impact and cost-effectiveness of 15-valent pneumococcal conjugate vaccine use among the pediatric population of the United States |
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| Affiliation: | 1. Respiratory Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, United States;2. Epidemic Intelligence Service, Centers for Disease Control and Prevention, United States;3. Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, United States;4. Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, United States;1. George Washington University Hospital, Department of Obstetrics and Gynecology, 900 23rd ST NW, Washington, DC 20037, United States;2. George Washington University, School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20052, United States;3. Sarasota Memorial Hospital, 1700 S Tamiami Trail, Sarasota, FL 34239, United States;1. Pfizer Vaccine Research and Development, 500 Arcola Rd, Collegeville, PA, USA;2. Vaccines, Antivirals and Evidence Generation, Pfizer Inc, 500 Arcola Rd, Collegeville, PA, USA;3. Pfizer Vaccine Clinical Research and Development, Horizon Building, Honey Lane, Hurley, SL6 6RJ, UK;1. Institute of Pharmaceutical Sciences, China Pharmaceutical University, Nanjing 211198, PR China;2. Clinical Stem Cell Center, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing 210008, PR China;3. Department of Pharmacoeconomics, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing 211198, PR China;4. Department of Infectious Diseases, Huangshi Love&Health Hospital, Huangshi 435000, PR China;5. Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, Nanjing 210008, PR China;6. Clinical Laboratory, Nanjing Yuhua Hospital (Yuhua Branch of Nanjing First Hospital), Nanjing 210039, PR China;1. Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection/Rheumatology, Linköping University, Linköping, Sweden;2. Central Hospital in Kristianstad, Department of Infectious Diseases and Department of Clinical Sciences, Section for Rheumatology, Lund University, Lund, Sweden;3. Department of Clinical Sciences, Lund, Section for Rheumatology, Lund University and Skåne University Hospital, Lund, Sweden;4. Department of Medicine, Solna, Division of Rheumatology, Karolinska University Hospital at Karolinska Institutet, Stockholm, Sweden;5. Department of Public Health and Clinical Medicine/Rheumatology, Umeå University, Umeå, Sweden;6. Wallenberg Centre for Molecular Medicine (WCMM), Umeå University, Umeå, Sweden;7. Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;8. Department of Clinical Sciences, Lund, Section for Nephrology, Lund University, Lund and Skåne University Hospital, Lund, Sweden;9. Department of Protein Science, SciLifeLab, KTH Royal Institute of Technology, Stockholm, Sweden |
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| Abstract: | BackgroundAlthough use of the 13-valent pneumococcal conjugate vaccine (PCV13) among children has reduced incidence of pneumococcal disease, a considerable burden of disease remains. PCV15 is a new vaccine that contains pneumococcal serotypes 22F and 33F in addition to serotypes contained in PCV13. To inform deliberations by the Advisory Committee on Immunization Practices on recommendations for PCV15 use among U.S. children, we estimated the health impact and cost-effectiveness of replacing PCV13 with PCV15 within the routine infant immunization program in the United States. We also assessed the impact and cost-effectiveness of a supplementary PCV15 dose among children aged 2–5 years who have already received a full PCV13 series.MethodsWe estimated the incremental number of pneumococcal disease events and deaths averted, costs per quality adjusted life-year (QALY) gained, and costs per life-year gained under different vaccination strategies using a probabilistic model following a single birth cohort of 3.9 million individuals (based on 2020 U.S. birth cohort). We assumed that vaccine effectiveness (VE) of PCV15 against the two additional serotypes was the same as the VE of PCV13. The cost of PCV15 use among children was informed from costs of PCV15 use among adults and from discussions with the manufacturer.ResultsOur base case results found that replacing PCV13 with PCV15 prevented 92,290 additional pneumococcal disease events and 22 associated deaths, while also saving $147 million in costs. A supplementary PCV15 dose among children aged 2–5 years who were fully vaccinated with PCV13 prevented further pneumococcal disease events and associated deaths but at a cost of more than $2.5 million per QALY gained.ConclusionsA further decrease in pneumococcal disease in conjunction with considerable societal cost savings could be expected from replacing PCV13 with PCV15 within the routine infant immunization program in the United States. |
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| Keywords: | PCV15 PCV13 Cost-effectiveness United States |
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