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A comparative analysis of pediatric pneumococcal vaccination strategies: a dynamic model of PCV20 vs. PCV15 and PCV13

Michele Wilson1, Benjamin M Althouse2, Aaron Lucas1

  • 1RTI Health Solutions, Research Triangle Park, NC, USA.

Vaccine
|February 26, 2026
PubMed

Insights

The 20-valent pneumococcal conjugate vaccine (PCV20) offers significant health and economic benefits for children in the US. Compared to PCV15 and PCV13, PCV20 reduces disease cases and healthcare costs, demonstrating its value.

Area of Science:

  • Vaccinology
  • Infectious Disease Epidemiology
  • Health Economics

Background:

  • The US pediatric immunization program includes both 20-valent (PCV20) and 15-valent (PCV15) pneumococcal conjugate vaccines.
  • Previous static models indicated PCV20's cost-effectiveness over PCV15 and the 13-valent vaccine (PCV13).

Purpose of the Study:

  • To evaluate the health and economic impact of PCV20 compared to PCV15 and PCV13 using a dynamic transmission model (DTM).

Main Methods:

  • An age-structured compartmental DTM simulated Streptococcus pneumoniae transmission in the US, calibrated to historical invasive pneumococcal disease (IPD) incidence.
  • The model assessed PCV20's impact versus PCV15 and PCV13 in the routine pediatric vaccination program.
  • Outcomes included disease cases (IPD, pneumonia, otitis media), quality-adjusted life-years (QALYs), and direct medical costs over a 10-year horizon.

Main Results:

  • PCV20 vaccination averted 4.0 million disease cases and saved $4.027 billion compared to PCV15.
  • PCV20 was dominant over PCV15, yielding 17,717 additional QALYs.
  • PCV20 also dominated PCV13, with $5.940 billion in savings and 26,099 additional QALYs.

Conclusions:

  • Pediatric PCV20 use is projected to decrease pneumococcal disease burden and healthcare expenditures in the US.
  • The findings support the health and economic advantages of adopting PCV20 for pediatric vaccination.
  • A higher-valent vaccination strategy with PCV20 demonstrates significant value.
Abstract

Keywords:
Cost-effectivenessDynamic transmission modelPneumococcal diseaseVaccination

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