Public health and budgetary impact of 20-valent pneumococcal conjugate vaccine for adults in England

Background Despite use of 23-valent pneumococcal polysaccharide vaccine (PPV23) in England, disease burden among at-risk adults remains high. We evaluated the public health and budgetary impact of 20-valent pneumococcal conjugate vaccine (PCV20) compared to the current adult pneumococcal vaccination program. Methods Five-year outcomes and costs of invasive pneumococcal disease (IPD) and community-acquired pneumonia (CAP) among adults aged 65-99 years and adults aged 18-64 years with underlying conditions in England were projected using a deterministic cohort model. Hypothetical vaccination with PCV20 versus PPV23 was compared from the National Health Service (NHS) perspective. Results Replacing PPV23 with PCV20 would prevent 785 IPD hospitalizations, 11,751 CAP hospitalizations, and 1,414 deaths over 5 years, and would reduce medical care costs by 48.5 pound M. With vaccination costs higher by 107.2 pound M, projected net budgetary impact is 58.7 pound M. The budgetary impact would be greatest in year 1 (26.3 pound M), and would decrease over time (to 1.6 pound M by year 5). The average budget increase (11.7 pound M/year) represents Conclusions Use of PCV20 among adults currently eligible for PPV23 in England would substantially reduce the burden of pneumococcal disease, with modest budgetary impact.