A 15-valent pneumococcal conjugate vaccine (V114) containing PCV13 serotypes and 22F/33F is under development. This study quantifies the health and economic burden of V114-type pneumococcal disease in Canadian children.
V114-type invasive pneumococcal disease (IPD) and acute otitis media (AOM) cases were simulated in a single, unvaccinated cohort from birth to 20 years with a Markov model. In the pre-PCV scenario, pre-PCV7 epidemiological inputs were used. In the post-PCV scenario, pre-PCV7, pre-PCV13 and current-day inputs were used to estimate PCV7, PCV13 not PCV7 (PCV13-PCV7), and 22F/33F disease, respectively. Costs were estimated from a societal perspective and discounted at 1.5%.
In the pre-PCV scenario, 600 V114-type IPD cases were attributable to PCV7 serotypes (n=535, 89%), PCV13-PCV7 serotypes (n=56, 9%), and 22F/33F (n=9, 2%); 715,642 V114-type AOM outpatient visits were attributable to PCV7 serotypes (n=519,286, 73%), PCV13-PCV7 serotypes (n=189,864, 27%), and 22F/33F (n=6,491, 1%). Total costs for V114-type IPD and AOM were CA$274 million. In the post-PCV scenario, PCV13-PCV7 serotypes increased, specifically serotypes 3, 19A and 7F for IPD, and 19A for AOM.
PCV7 serotypes cause most pneumococcal morbidity and are important to retain in PCVs. Select PCV13-PCV7 serotypes also contribute to the disease burden. Including non-vaccine serotypes can prevent additional disease burden.