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Modelling the Epidemiological Impact of Different Adult Pneumococcal Vaccination Strategies in the United Kingdom
Rachel J Oidtman1, Giulio Meleleo2, Oluwaseun Sharomi3
1Merck & Co., Inc., Rahway, NJ, USA. rachel.oidtman@merck.com.
Insights
The new V116 pneumococcal vaccine significantly reduces invasive pneumococcal disease (IPD) in adults aged 65+ compared to PCV20 or PPSV23. This finding highlights V116 as a promising strategy for improving adult immunization programs.
Area of Science:
- Immunology
- Epidemiology
- Public Health
Background:
- Pneumococcal conjugate vaccines (PCVs) introduced in 2006 reduced invasive pneumococcal disease (IPD) in UK children.
- Despite indirect protection from pediatric PCVs, a substantial IPD burden persists in older adults.
- Current adult vaccination strategies include PPSV23 and PCV20, with V116 being a new adult-focused option.
Purpose of the Study:
- To compare the effectiveness of three adult vaccination scenarios against invasive pneumococcal disease (IPD) in the UK.
- To evaluate the impact of continuing PPSV23 vaccination, using PCV20, or implementing the new V116 vaccine in adults aged 65+ and at-risk individuals aged 2-64.
- To project the long-term incidence of IPD under different vaccination strategies.
Main Methods:
- A dynamic transmission model (DTM) was adapted for the UK setting, incorporating Streptococcus pneumoniae carriage and disease progression.
- The DTM was calibrated using age- and serotype-specific IPD data from the UK.
- The model projected IPD incidence under three scenarios: continued PPSV23 use, PCV20 use, and V116 use, while maintaining pediatric PCV13 immunization.
Main Results:
- Model calibration showed good agreement with observed IPD dynamics.
- In adults aged 65+, V116 is projected to reduce IPD incidence by 15.5% over 10 years.
- PCV20 is projected to reduce IPD by 8.9%, while PPSV23 use is predicted to increase incidence by 3.83%.
Conclusions:
- The V116 vaccine demonstrated superior efficacy in reducing IPD among adults aged 65+ compared to PCV20 and PPSV23.
- V116 led to a notable decrease in IPD caused by its unique serotypes.
- No resurgence of IPD was predicted in serotypes covered by PCV20 but not V116.
Introduction:
Pneumococcal conjugate vaccines (PCVs) were first introduced in the paediatric United Kingdom (UK) immunisation programme in 2006 which led to significant declines in invasive pneumococcal disease (IPD) caused by targeted serotypes. Although paediatric PCVs provide some indirect protection to adults, a significant IPD burden remains in older adults. Here, we compared three adult (65+ years-old) and risk group (2-64-year-old) vaccination scenarios, namely a continuation of the status quo with PPSV23 vaccination, using the recently licensed-in-adults PCV20, or using the new adult-focused 21-valent PCV, V116.
Methods:
A population-level compartmental dynamic transmission model (DTM) was adapted to the UK setting. The model described Streptococcus pneumoniae carriage transmission dynamics and disease progression in the presence of age- and serotype-specific pneumococcal vaccines. We calibrated the DTM to age- and serotype-specific IPD data in the UK and used the model to make projections under the different adult vaccination scenarios while keeping PCV13 immunisation in children.
Results:
The calibrated model yielded reasonable parameter values and model fits that closely matched observed IPD dynamics. Among 65+ year-olds, 10-year model projections predicted that the routine use of V116 would reduce IPD incidence by 15.5%, while PCV20 would reduce IPD incidence by 8.9% and the continued use of PPSV23 would increase incidence by 3.83%. There was a notable decrease in IPD incidence in the serotypes unique to V116. In the serotypes included in PCV20 but not V116, the model did not predict a resurgence of IPD.
Conclusions:
Projections revealed that in adults, V116 led to significantly greater reductions in IPD in the 65+ year-old population compared with PCV20 or PPSV23.
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