ArticleHuman vaccines & immunotherapeutics2026
Optimizing pneumococcal prevention in South African older adults: Cost-effectiveness of PCV20 versus PPSV23 in the context of HIV-associated risk.
Article in Human vaccines & immunotherapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pneumococcal disease remains a major cause of morbidity and mortality among older adults in South Africa, particularly among people living with HIV. Evidence on the cost-effectiveness of Prevnar 20 (PCV20) vs. Pneumovax 23 (PPSV23) vaccine in this setting remains limited. This study was conducted to evaluate the cost-effectiveness of PCV20 compared with PPSV23 vaccine among adults aged ≥65y in South Africa, and to assess the impact of HIV stratification on economic outcomes. A static decision-tree model was developed from the South African public healthcare payer perspective. The analysis incorporated invasive pneumococcal disease, pneumococcal community-acquired pneumonia, quality-adjusted life-years, maximum acceptable price, and 5y budget impact. HIV-stratified incidence and CD4-adjusted vaccine effectiveness were included. In the general population, PCV20 provided greater health benefits than PPSV23 but was not cost-effective at the current base-case price (USD 20.00/dose), with an ICER of USD 17,323/QALY. Price was the main driver of cost-effectiveness. In contrast, targeted vaccination of older adults living with HIV was economically favorable, with an ICER of USD 2,104/QALY under national incidence assumptions, and even stronger results in high-burden settings. The cost-effectiveness of PCV20 in South Africa is contingent upon the price of vaccine and risk-based targeting. Vaccinating all older adults universally may not be cost-effective at current prices, suggesting that targeted vaccination of older adults with HIV represents a more efficient strategy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.