Predicting the Epidemiological Effects in the United Kingdom of Moving from PCV13 to PCV15 in the Routine Pediatric 1 + 1 Vaccination Schedule

TL;DR

This study compares the public health impact of using PCV15 versus PCV13 vaccines in the UK's pediatric vaccination schedule and finds PCV15 leads to lower disease rates.

Contribution

The study evaluates the epidemiological effects of switching from PCV13 to PCV15 under a 1 + 1 dosing schedule in the UK.

Findings

PCV15 under a 1 + 1 schedule led to a 6.0% lower IPD incidence than PCV13 in the overall population after 20 years.

PCV13 under a 1 + 1 schedule caused an 11.1% increase in IPD incidence in children under 2 years old.

PCV15 showed a 3.5% increase in IPD incidence in children under 2 years old compared to pre-vaccination levels.

Abstract

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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