Background/Objectives: The clinical impact of replacing the 23-valent pneumococcal polysaccharide vaccine (PPSV23) for the vaccination of older (≥60 years) and at-risk German adults with either the 20-valent (PCV20) or 21-valent (V116) pneumococcal conjugate vaccine (PCV) was evaluated. Methods: An age- and serotype-specific transmission model was adapted to Germany to evaluate the impact of V116 versus PCV20 vaccination on pneumococcal disease (PD) incidence, including invasive pneumococcal disease (IPD) and inpatient and outpatient non-bacteremic pneumococcal pneumonia, over 10 years. A reference strategy (PPSV23 vaccination at a constant 30% vaccine coverage rate (VCR)) was compared against eight strategies varying by PCV (PCV20 vs. V116), VCR (30% vs. 60%), with or without the PCV revaccination of previously PPSV23-vaccinated adults (0% vs. 50% revaccination). Results: Vaccination with PCV20 and V116 initially decreased PD incidence, but incidence returned to pre-vaccine levels after five and eight years, respectively. Increasing the VCR to 60% prevented this resurgence. At a 10-year time horizon, V116 with 30% VCR reduced IPD cases by 9%, inpatient NBPP cases by 10%, and outpatient NBPP cases by 7% compared to the reference strategy. PCV20 with 30% VCR reduced these cases by 6%, 5%, and 4%, respectively. Increasing the VCR to 60% and revaccinating 50% of previously PPSV23-vaccinated adults further reduced IPD cases by 14% and 13% for V116, and by 9% and 9% for PCV20. Conclusions: Increasing the vaccination coverage rate to 60% and strategically revaccinating previously PPSV23-vaccinated adults significantly enhanced the effectiveness of pneumococcal vaccines, with V116 showing greater overall reductions in disease incidence compared to PCV20 or PPSV23.

Paediatric check-ups and vaccinations are provided and free of charge in Germany. Despite being hitherto generally well-received and adhered to, it is possible that the lockdown implemented due to the COVID-19 pandemic resulted in delays or even cancellations of critical paediatric visits with healthcare providers. This study attempts to quantify the rate and time to follow-up for check-ups in Germany using the retrospective IQVIA^TM Disease Analyzer database. Additionally, timely administration of 4 vaccines (Hexavalent, pneumococcal, MMR-V, Rotavirus) was analysed to examine the impact of pandemic restrictions on vaccine uptake. The timeframes which were compared to determine the effects of COVID-19 were June 2018–December 2019 and March 2020–September 2021. The follow-up rates for paediatric check-ups were consistently lower in the COVID-19 phase, but generally ~90%. Follow-up rates for the vaccinations were distinctly higher during COVID-19. The time between events was almost unchanged for check-ups during the pandemic. For check-ups, age at initial event differed by less than a week between the phases. For vaccinations, the age differences were slightly higher, but exceeded one week in only two cases. The results show that the COVID-19 pandemic had little effect on paediatric check-ups and vaccinations in Germany.