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Predicting the Epidemiological Effects in the United Kingdom of Moving from PCV13 to PCV15 in the Routine Pediatric 1
Rachel J Oidtman1, Natalie Banniettis1, Jessica Weaver1
1Merck & Co., Inc., Rahway, NJ 07065, USA.
Insights
Switching to pneumococcal conjugate vaccine 15 (PCV15) from PCV13 in the UK pediatric National Immunization Programme (NIP) with a 1+1 schedule is projected to lower invasive pneumococcal disease (IPD) incidence in children and the overall population.
Area of Science:
- Immunology
- Epidemiology
- Public Health
Background:
- Pneumococcal conjugate vaccines (PCVs) significantly reduced invasive pneumococcal disease (IPD) in the UK pediatric National Immunization Programme (NIP) since 2006.
- The UK NIP shifted to a 1+1 pediatric PCV dosing schedule in 2020, reducing doses from 2+1.
Purpose of the Study:
- To evaluate the public health impact of using PCV15 versus PCV13 under the current 1+1 pediatric dosing schedule.
- To compare the effectiveness of PCV15 and PCV13 in reducing IPD incidence over a 20-year period.
Main Methods:
- A UK-adapted population-level compartmental model was utilized to simulate IPD incidence.
- Probabilistic sensitivity analysis assessed uncertainty in vaccine efficacy (VE) for PCV13 and PCV15 under the 1+1 schedule, assuming 0-24% lower VE than the 2+1 schedule.
- The model projected outcomes over a 20-year time horizon.
Main Results:
- Under the 1+1 schedule, PCV15 vaccination resulted in a 3.5% increase in IPD incidence in children <2 years old, compared to an 11.1% increase with PCV13.
- Over 20 years, PCV15 is predicted to yield a 6.0% lower overall IPD incidence than PCV13 (10.70 vs. 11.38 cases per 100,000 population).
Conclusions:
- Transitioning from PCV13 to PCV15 for routine pediatric vaccination in the UK, using a 1+1 schedule, is associated with reduced IPD incidence.
- PCV15 demonstrates superior effectiveness in lowering IPD rates in both pediatric and the general population compared to PCV13 under the 1+1 dosing strategy.
Background/Objectives:
Pneumococcal conjugate vaccines (PCVs) were first introduced in the pediatric UK National Immunization Programme (NIP) in 2006 and subsequently led to a significant decline in invasive pneumococcal disease (IPD). In 2020, the UK NIP reduced the pediatric PCV dosing schedule from two infant doses and one toddler dose (2 + 1) to one infant dose and one toddler dose (1 + 1). This analysis evaluated the public health impact of pediatric vaccination with PCV15 versus PCV13 under a 1 + 1 schedule.
Methods:
A population-level compartmental model was previously adapted to the UK setting. The impact on the IPD incidence of vaccination with PCV15 versus PCV13 under a 1 + 1 schedule was evaluated over a 20-year time horizon. The uncertainty regarding the vaccine efficacy (VE) of PCV13 and PCV15 under a 1 + 1 schedule was investigated through a probabilistic sensitivity analysis, i.e., the PCV VE under a 1 + 1 schedule was assumed to be 0-24% lower than the PCV VE under a 2 + 1 schedule.
Results:
Relative to the initial IPD incidence, vaccination with PCV13 and PCV15 under a 1 + 1 schedule resulted in the IPD incidence in children <2 years old increasing by 11.1% (95% region: 8.4-14.5%) and 3.5% (0.2-7.7%), respectively, over the time horizon. At the end of the time horizon, in the overall population, PCV15 would lead to a 6.0% lower IPD incidence than PCV13 (10.70 IPD cases per 100,000 versus 11.38 per 100,000, respectively).
Conclusions:
Switching from PCV13 to PCV15 for routine pediatric vaccinations under the 1 + 1 dosing schedule in the UK led to a lower IPD incidence in both the pediatric and overall populations.
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