Kedokteran & Kesehatan editorial
Open AccessOA2024
Cost-effectiveness and public health impact of 24-valent pneumococcal conjugate vaccine compared to recommended pneumococcal vaccines in older adults
A decision analysis comparing the in-development 24-valent pneumococcal conjugate vaccine (PCV24) to currently recommended vaccines in US adults aged ≥65 years found that PCV21 prevented more disease and was economically favorable. These findings were robust across sensitivity analyses.
Kenneth J. Smith; A. Wateska; M. Nowalk; Chyongchiou J. Lin; Lee H. Harrison; William Schaffner; Richard K. Zimmerman· American Journal of Preventive Medicine· 2024· DOI 10.1016/j.amepre.2024.11.014
The core problem
The potential public health and economic impact of an in-development 24-valent pneumococcal conjugate vaccine (PCV24) compared with currently recommended pneumococcal vaccines in older adults is unclear. Similar to most currently available PCVs, PCV24's formulation is based on childhood pneumococcal disease epidemiology. This study used decision analysis techniques to estimate the cost-effectiveness and public health effects of PCV24 in US older adults.
Innovation
A Markov model was developed to compare PCV24 with currently recommended US pneumococcal vaccination strategies in adults aged ≥65 years and with no vaccination. Age-, race-, and chronic medical condition-specific pneumococcal illness risks and serotype-specific disease risks were obtained from CDC data. Vaccine effectiveness was estimated using Delphi panel and clinical trial data. Vaccination and pneumococcal illness costs were derived from US databases. Scenario analyses examined the indirect effects of childhood pneumococcal vaccination on adult disease. Data were collected and analyses performed in 2024.
Introduction
The potential public health and economic impact of an in-development 24-valent pneumococcal conjugate vaccine (PCV24) compared with currently recommended pneumococcal vaccines in older adults is unclear. Similar to most currently available PCVs, PCV24's formulation is based on childhood pneumococcal disease epidemiology. This study used decision analysis techniques to estimate the cost-effectiveness and public health effects of PCV24 in US older adults.
Why it matters
The study concludes that in older adults, PCV24 was clinically and economically unfavorable compared to PCV21. PCV21 covers more adult disease-causing pneumococcal serotypes and is less susceptible to childhood vaccination indirect effects. These results suggest that PCV21 should be preferred over PCV24 for pneumococcal vaccination in older adults, and highlight the importance of formulating vaccines based on adult-specific disease epidemiology.
Who should read this
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