Serotype Replacement after Introduction of 10-Valent and 13-Valent Pneumococcal Conjugate Vaccines in 10 Countries, Europe

ABSTRACTStreptococcus pneumoniae remains a leading cause of morbidity and mortality. Pneumococcal conjugate vaccines (PCVs) are effective but target only a fraction of the more than 90 pneumococcal serotypes. As a result, the introduction of PCVs has been followed by the emergence of non-vaccine serotypes. With higher-valency PCVs currently under development, there is a need to understand and predict patterns of serotype replacement to anticipate future changes. In this study, we evaluated patterns of change in serotype prevalence post-PCV introduction in Israel. We found that the assumption that non-vaccine serotypes increase by the same proportion overestimates changes in serotype prevalence in Jewish and Bedouin children. Furthermore, pre-vaccine prevalence was positively associated with increases in prevalence over the study period. From our analyses, serotypes 12F, 8, 16F, 33F, 9N, 7B, 10A, 22F, 24F, and 17F were estimated to have gained the most cases of invasive pneumococcal disease through serotype replacement in the Jewish population. However, this model also failed to quantify some additional cases gained, suggesting that changes in carriage in children alone may be insufficient to explain serotype replacement in disease. Understanding of serotype replacement is important as higher-valency vaccines are introduced.

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Pneumococcal Diseases Caused by Serotype Replacement in Colombia: A Cost-Effectiveness Analysis of Pneumococcal Conjugate Vaccines in Infants and Its Herd Protection in Older Adults

10.21203/rs.3.rs-72778/v1 ◽

2020 ◽

Author(s):

Jaime E. Ordóñez ◽

Angélica Ordóñez

Keyword(s):

Older Adults ◽

Acute Otitis Media ◽

Pneumococcal Vaccination ◽

Indirect Costs ◽

Economic Benefits ◽

Community Acquired Pneumonia ◽

Conjugate Vaccines ◽

Pneumococcal Conjugate Vaccines ◽

Serotype Replacement ◽

Strategy Versus

Abstract Background. The recent and available evidence on the distribution of pneumococcal serotypes, which affects the effectiveness of pneumococcal conjugate vaccines (PCV), suggest that additional health economic studies will be important for better understanding of potential economic benefits of pneumococcal vaccination. Methods A cohort simulation model was used for new births in Colombia between 2019-2022 and adults over 65 years, from social perspective (direct and indirect costs). The time horizon was a life expectancy and discount rate for costs and benefits of 5%. The outcomes were presented in terms of avoided pneumococcal diseases ─ Invasive Pneumococcal Disease (IPD), Community Acquired Pneumonia (CAP), Acute Otitis Media (AOM), and sequelae─, years of life gained (AVG) and herd effect in older adults.Results. Based on data from National Data of the serotype distribution between 2017-2019, PCV10 covers 5% of serotypes while PCV13 63%. The additional cases that PCV13 would prevent are in children: 1,205 cases of IPD, 60,274 of CAP, 26,619 of AOM, 3,980 deaths, 28 cases of neuromotor disability and 1,251 cochlear implants. In older adults, PCV13 would prevent 818 additional cases of IPD and 29,983 of CAP, generating 149,186 additional LYGs to those of PCV10 with a saving to the health system and patients of US $ 169,261 thousand. The model shows robustness in the sensibility analysis.Conclusion. PCV13 is a cost-saving strategy versus PCV10 to prevent pneumococcal diseases.

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