Projected health and economic impact of PCV20 vaccination in UK children: a dynamic transmission model.

BACKGROUND

Despite the significant impact of longstanding pediatric pneumococcal conjugate vaccine (PCV) use in the United Kingdom (UK), pneumococcal disease burden remains substantial. Higher valent vaccines, such as the 20‑valent PCV (PCV20), could reduce this burden, yet their value in the contemporary UK setting has not been fully assessed using recent data.

RESEARCH DESIGN AND

METHODS

An age-structured dynamic transmission model used post-COVID-19 UK epidemiology (2001-2023) to compare pediatric PCV20 (2 + 1 and 1 + 1) with PCV13 (1 + 1) and PCV15 (1 + 1). Over 10 years, we assessed cost-effectiveness and number needed to vaccinate (NNV), capturing disease cases, deaths, costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. Sensitivity and scenario analyses examined key uncertainties.

RESULTS

Over 10 years, both PCV20 schedules were dominant versus PCV13 and PCV15. Versus PCV13, PCV20 1 + 1 and 2 + 1 were projected to avert 448,432 and 499,151 disease cases and save £1.509 and £1.306 billion, respectively. Versus PCV15, PCV20 1 + 1 and 2 + 1 were projected to avert 409,459 and 460,179 disease cases and save £1.424 and £1.221 billion, respectively. NNVs versus PCV13 were lower for PCV20 than PCV15 across both dosing schedules. Sensitivity and scenario results were consistent with the base case.

CONCLUSION

Pediatric PCV20 implementation in the UK could deliver substantial health gains while improving economic efficiency.