ArticleJournal of the American Geriatrics Society2024
Changes in the cost-effectiveness of pneumococcal vaccination and of programs to increase its uptake in U.S. older adults.
Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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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
7 citing papers in PubMed, 1 synthesis or guideline pooled 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
- Optimizing pneumococcal prevention in South African older adults: Cost-effectiveness of PCV20 versus PPSV23 in the context of HIV-associated risk.Human vaccines & immunotherapeutics · 2026Article
- Cost-utility of pneumococcal strategies for adults aged 50 and older in Colombia: a model-based economic evaluation.BMC health services research · 2026Article
- Public health effects of adult pneumococcal vaccination choice amid increased serotype 4 rates in US subpopulations.Public health · 2025Article
- 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
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundMultiple factors, such as less complex U.S. adult pneumococcal recommendations that could increase vaccination rates, childhood pneumococcal vaccination indirect effects that decrease adult vaccination impact, and increased vaccine hesitancy (particularly in underserved minorities), could diminish the cost-effectiveness of programs to increase pneumococcal vaccination in older adults. Prior analyses supported the economic favorability of these programs.
methodsA Markov model compared no vaccination and current recommendations (either 20-valent pneumococcal conjugate vaccine [PCV20] alone or 15-valent pneumococcal conjugate vaccine plus the 23-valent pneumococcal polysaccharide vaccine [PCV15/PPSV23]) without or with programs to increase vaccine uptake in Black and non-Black 65-year-old cohorts. Pre-pandemic population- and serotype-specific pneumococcal disease risk and illness/vaccine costs came from U.S. DATABASES: Program costs were $2.19 per vaccine-eligible person and increased absolute vaccination likelihood by 7.5%. Delphi panel estimates and trial data informed vaccine effectiveness values. Analyses took a healthcare perspective, discounting at 3%/year over a lifetime time horizon.
resultsUptake programs decreased pneumococcal disease overall. In Black cohorts, PCV20 without program cost $216,805 per quality-adjusted life year (QALY) gained compared with no vaccination; incremental cost-effectiveness was $245,546/QALY for PCV20 with program and $425,264/QALY for PCV15/PPSV23 with program. In non-Black cohorts, all strategies cost >$200,000/QALY gained. When considering the potential indirect effects from childhood vaccination, all strategies became less economically attractive. Increased vaccination with less complex strategies had negligible effects. In probabilistic sensitivity analyses, current recommendations with or without programs were unlikely to be favored at thresholds <$200,000/QALY gained.
conclusionCurrent U.S. pneumococcal vaccination recommendations for older adults were unlikely to be economically reasonable with or without programs to increase vaccine uptake. Alternatives to current pneumococcal vaccines that include pneumococcal serotypes associated with adult disease should be considered.
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