Authors' objectives:

Given the sharp rise currently observed in serotypes 1, 5 and 7F in Belgium and the relatively low impact of PCV7 vaccination, a switch from PCV7 to the new PCV vaccines seems favourable, as both of them cover these serotypes. However, which new vaccine should be preferred is difficult to establish. PCV10 may provide a higher protection against AOM, while PCV13 offers a wider coverage of serotypes causing IPD (certainly against the rising 19A serotype). The choice between these vaccines must also be made in a context of uncertainty regarding future serotype replacement (as other rising serotypes are not covered by the new vaccines) and taking into account vaccine prices.
In view of the availability of these new vaccines, the present report aims to estimate the incremental effectiveness and cost-effectiveness of replacing PCV7 by either PCV10 or
PCV13 in Belgium, taking into account the herd immunity and serotype replacement.

Authors' recommendations: In conclusion, according to the results of our model, the case for replacing the current PCV7 vaccine by the new PCV10 or PCV13 vaccines is strong. The results also clearly show that a 2+1 schedule is more desirable than a 3+1 schedule. However, the choice between the PCV10 and PCV13 vaccines is not obvious. The analysis and interpretation of the cost-effectiveness results of our modelling analysis is made difficult due to the uncertain nature of the future serotype replacement and herd immunity effects, and of the alleged 19A cross-protection and NTHi AOM effect from PCV10. Changing those assumptions within reasonable ranges made indeed alternately PCV13 preferred to PCV10 or the opposite, with the assumptions about serotype replacement and PCV10 effectiveness against AOM and serotype 19A having the strongest impact on those results. Clearly the choice between both vaccines will depend on the preference of the decision-maker to opt for the prevention of the less-frequent severe IPD cases only, or to also consider the prevention of the high caseload of AOM. The price at which both vaccines will be offered will also play a crucial role, stressing the importance of the tendering procedure to obtain lower vaccine prices.

Project Status: Completed

URL for project: https://kce.fgov.be/publication/report/cost-effectiveness-of-10-and-13-valent-pneumococcal-conjugate-vaccines-in-childho

Year Published: 2011

URL for published report: https://kce.fgov.be/publication/report/cost-effectiveness-of-10-and-13-valent-pneumococcal-conjugate-vaccines-in-childho

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Belgium

Organisation Name: Belgian Health Care Knowledge Centre

Contact Address: Administrative Centre Botanique, Doorbuilding (10th floor), Boulevard du Jardin Botanique 55, B-1000 Brussels, Belgium tel: +32 2 287 33 88 fax: +32 2 287 33 85

Contact Name: info@kce.fgov.be

Contact Email: info@kce.fgov.be

Copyright: Belgian Health Care Knowledge Centre (KCE)