In June 2010, Greece introduced the 13-valent pneumococcal conjugate vaccine (PCV13) for pediatric vaccination and has since observed a large decrease in pneumococcal disease caused by these vaccine serotypes, yet the disease prevalence of non-vaccine serotypes has increased. Two higher-valent conjugate vaccines, a 15-valent (PCV15) and a 20-valent (PCV20), were developed to improve serotype coverage and combat serotype replacement. A decision-analytic model was adapted to the Greek setting using historical pneumococcal disease trends from PCV13 to forecast future clinical and economic outcomes of higher-valent PCVs over a 10-year period (2023–2033). The model estimated outcomes related to invasive pneumococcal disease (IPD), hospitalized and non-hospitalized pneumonia, and otitis media (OM) resulting from a switch in vaccination programs to PCV15 in 2023 or switching to PCV20 in 2024. Cost-effectiveness was evaluated from the third-party payer’s perspective in the Greek healthcare system. Compared to implementing PCV15 one year earlier, switching from PCV13 to PCV20 in 2024 was estimated to be a cost-saving strategy by saving the Greek health system over EUR 50 million in direct medical costs and averting over 250 IPD cases, 54,800 OM cases, 8450 pneumonia cases, and 255 deaths across all ages over a 10-year period.

Introduction: The widespread implementation of pneumococcal conjugate vaccines (PCVs) into pediatric national immunization programs (NIPs) across Latin American countries has substantially reduced pneumococcal disease burden. While the 10-valent (PCV10) and 13-valent (PCV13) vaccines have reduced morbidity and mortality, disease caused by serotypes not included in these vaccines persists. The 15-valent (PCV15) and 20-valent (PCV20) vaccines are now available in the region. This study aimed to estimate the clinical, economic, and societal burden attributable to serotypes contained in PCV10, PCV13, PCV15, and PCV20 in children aged <5 years in Argentina, Chile, Mexico, Colombia, and Brazil Methods: Using country-specific epidemiological, cost, and population inputs, we applied a static Excel-based model to estimate annual pneumococcal disease cases, deaths, direct medical costs, and indirect societal costs resulting from caregiver productivity losses. Burden was estimated for serotypes included in PCV10, PCV13, PCV15, and PCV20, and results were interpreted in the context of the vaccine included in each country's pediatric NIP as of 2019. Results: Across the five countries, PCV20 serotypes were estimated to cause over 510,000 pneumococcal disease cases and approximately 2,700 deaths annually. This corresponded to an annual economic burden exceeding USD $182 million and a societal burden exceeding USD $34 million. Non-invasive disease, particularly pneumonia and otitis media, accounted for most of the clinical, economic, and societal burden. In countries using PCV10 in their NIP, a substantial proportion of remaining disease burden was attributable to serotypes included in PCV13 but not PCV10. Across all countries, serotypes unique to PCV15 contributed little additional burden beyond PCV13, whereas serotypes unique to PCV20 accounted for a substantial share of remaining disease burden, particularly in PCV13 NIP countries. Conclusion: Despite the success of PCV10 and PCV13 in reducing pneumococcal disease in Latin America, a considerable clinical, economic, and societal burden remains due to serotypes included in higher-valent vaccines. Broader serotype coverage offered by PCV20 has the potential to address this unmet burden and further reduce the public health and economic impact of pneumococcal disease in young children across the region.

Background: Despite the significant impact of longstanding paediatric pneumococcal conjugate vaccine (PCV) use in the United Kingdom (UK), pneumococcal disease burden remains substantial and is primarily driven by nonl1lPCV13 serotypes. Higherl1lvalent vaccines such as the 20l1lvalent PCV (PCV20) may provide additional public health and economic benefits, yet their value in the contemporary UK setting has not been fully assessed using recent data. Methods: We updated an agel1lstructured dynamic transmission model using postl1lCOVIDl1l19 UK epidemiology (2001–2023) to compare pediatric PCV20 with PCV13 and PCV15. Over a 10-year horizon, we assessed cost-effectiveness and number needed to vaccinate (NNV), capturing invasive and non-invasive disease cases, deaths, costs, quality-adjusted life-years, and incremental cost-effectiveness ratios. PCV20 was evaluated under 1+1 and 2+1 schedules; PCV13 and PCV15 were assessed under 1+1. Scenario analyses examined key uncertainties. Results: PCV20 was estimated to avert more cases and deaths than PCV13 or PCV15, driven by broader serotype coverage and indirect effects. Both PCV20 schedules were dominant or cost-saving versus lower-valent comparators, with lower NNVs. PCV20’s higher vaccination costs were offset by reductions in downstream healthcare expenditures. Conclusion: Paediatric PCV20 implementation in the UK could deliver substantial health gains while improving economic efficiency, supporting timely adoption.