ArticleBMC medicine2024
Higher-valency pneumococcal conjugate vaccines in older adults, taking into account indirect effects from childhood vaccination: a cost-effectiveness study for the Netherlands.
Article in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Consideration of intersectoral costs and benefits in health economic evaluations of pneumococcal conjugate vaccines: a systematic review.International journal of technology assessment in health care · 2026Pooled it
- Use of Health State Utility Values in Cost-Utility Analyses of Selected Infectious Diseases in Aging Populations: A Systematic Review and Critical Appraisal.PharmacoEconomics - open · 2026Pooled it
- Cost effectiveness and public health impact of PCV20 among adults in France.BMC public health · 2026Article
- Article
- The global threat of vaccine-preventable neurological diseases.Nature reviews. Neurology · 2026Review
- Article
- Cost-effectiveness analyses of 20-valent pneumococcal conjugate vaccine in children and adults: A narrative review.Human vaccines & immunotherapeutics · 2025Review
- Recommendations on PCV20 vaccine in adults and at-risk populations.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Article
- Article
- Economic Evaluation of Transitioning to the 20-Valent Pneumococcal Conjugate Vaccine in the Dutch Paediatric National Immunisation Programme.Infectious diseases and therapy · 2025Article
- Cost effectiveness of a 21-valent pneumococcal conjugate vaccine in adults: A systematic review of economic evaluations.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2025Article
- Cost-effectiveness analysis of the 13-valent pneumococcal conjugate vaccine administered to children under 5 years of age in the Republic of Moldova.Medicine and pharmacy reports · 2025Article
- A decade of 10-valent pneumococcal conjugate vaccine use in Lithuania: trends in invasive pneumococcal serotype dynamics.Frontiers in public health · 2025Article
- Cost-Effectiveness of the Pneumococcal Vaccine in the Adult Population: A Systematic Review.Healthcare (Basel, Switzerland) · 2024Review
- Cost-Effectiveness Analysis of the Use of V116, a 21-Valent Pneumococcal Conjugate Vaccine, in Vaccine-Naïve Adults Aged ≥ 65 Years in the United States.Infectious diseases and therapy · 2024Article
- Improving Vaccine Assessment Pathways and Decision Making in the Polish Immunization Program.Vaccines · 2024Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNew 15- and 20-valent pneumococcal vaccines (PCV15, PCV20) are available for both children and adults, while PCV21 for adults is in development. However, their cost-effectiveness for older adults, taking into account indirect protection and serotype replacement from a switch to PCV15 and PCV20 in childhood vaccination, remains unexamined.
methodsWe used a static model for the Netherlands to assess the cost-effectiveness of different strategies with 23-valent pneumococcal polysaccharide vaccine (PPV23), PCV15, PCV20, and PCV21 for a 65-year-old cohort from a societal perspective, over a 15-year time horizon. Childhood vaccination was varied from PCV10 to PCV13, PCV15, and PCV20. Indirect protection was assumed to reduce the incidence of vaccine serotypes in older adults by 80% (except for serotype 3, no effect), completely offset by an increase in non-vaccine serotype incidence due to serotype replacement.
resultsIndirect effects from childhood vaccination reduced the cost-effectiveness of vaccination of older adults, depending on the serotype overlap between the vaccines. With PCV10, PCV13, or PCV15 in children, PCV20 was more effective and less costly for older adults than PPV23 and PCV15. PCV20 costs approximately €10,000 per quality-adjusted life year (QALY) gained compared to no pneumococcal vaccination, which falls below the conventional Dutch €20,000/QALY gained threshold. However, with PCV20 in children, PCV20 was no longer considered cost-effective for older adults, costing €22,550/QALY gained. As indirect effects progressed over time, the cost-effectiveness of PCV20 for older adults further diminished for newly vaccinated cohorts. PPV23 was more cost-effective than PCV20 for cohorts vaccinated 3 years after the switch to PCV20 in children. PCV21 offered the most QALY gains, and its cost-effectiveness was minimally affected by indirect effects due to its coverage of 11 different serotypes compared to PCV20.
conclusionsFor long-term cost-effectiveness in the Netherlands, the pneumococcal vaccine for older adults should either include invasive serotypes not covered by childhood vaccination or become more affordable than its current pricing for individual use.
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Registered trials
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