The Health and Economic Impact of the Adult-specific 21-valent (aPCV21) Pneumococcal Conjugate Vaccine vs PCV20 on Invasive Pneumococcal Disease Among Adults Aged 65 years in the United Kingdom: A Modeling Study
- 1Merck & Co., Inc., Rahway, NJ, USA
Abstract
IntroductionThis study compared the health and economic impact of the 21-valent pneumococcal conjugate vaccine (aPCV21) vs the 20-valent pneumococcal conjugate vaccine (PCV20) on invasive pneumococcal disease (IPD) and post-meningitis sequelae (PMS) among adults aged 65 years and older in the United Kingdom (UK).
MethodsA published Markov model was used to simulate a single-cohort of vaccine-naive adults who became eligible for age-based vaccination at age 65 years, with uptake occurring over time. The cohort was followed until a maximum age of 100 years. Model inputs were derived from publicly available national health data and published reports. Outcomes were discounted at 3.5% annually, and costs were adjusted to the 2024 Great Britain Pound ({pound}). Additional analyses explored the impact of changing the age-based recommendation from 65 years to 75 years. Scenarios involving instantaneous vaccine uptake rates were included as part of the sensitivity analyses. A deterministic sensitivity analysis was performed on the incremental direct medical costs between vaccinating with aPCV21 vs PCV20 under the age-based recommendation of 65 years.
ResultsUsing an age-based recommendation of 65 years, aPCV21 led to fewer cases, deaths, and costs than PCV20. Compared with PCV20, aPCV21 averted an additional 138 IPD cases, 1 PMS case, and 22 IPD deaths, saving {pound}1.2 million in direct medical costs. Raising the age-based recommendation from 65 to 75 years and using aPCV21 (or PCV20, respectively), resulted in 120 (92) additional IPD cases, 2 (1) additional PMS case(s), 19 (14) additional IPD death(s), and an extra {pound}1.1 ({pound}0.8) million in direct medical costs. The deterministic sensitivity analysis showed that aPCV21 reduced direct medical costs across all parameter ranges.
ConclusionsCompared with PCV20, aPCV21 prevented more IPD cases, IPD deaths, and direct medical costs among older adults in the UK. Changing the age-based recommendation from age 65 to 75 resulted in worse health and economic outcomes.
Related
- Antimicrobial resistance trends and lineage distribution among invasive pneumococcal disease isolates pre- and post-pneumococcal conjugate vaccine introduction, South Africa
- Cost-effectiveness of 20-valent versus 15-valent pneumococcal conjugate vaccines for infants in the Netherlands, taking into account indirect effects and adult vaccination
- Recommendations for Adult Pneumococcal Vaccination in Korea: 2026 Update Incorporating the 21-Valent Pneumococcal Conjugate Vaccine.
- The immunogenicity of pneumococcal conjugate vaccinations in patients with asplenia and hyposplenia: a systematic review
- Effectiveness of 20-valent pneumococcal conjugate vaccine against pneumococcal pneumonia hospitalizations among U.S. adults: Test-Negative Design
BibTeX
@misc{mueller2026health,
title = {{The Health and Economic Impact of the Adult-specific 21-valent (aPCV21) Pneumococcal Conjugate Vaccine vs PCV20 on Invasive Pneumococcal Disease Among Adults Aged 65 years in the United Kingdom: A Modeling Study}},
author = {P. P. Mueller and M. Simuzingili and I. R. Matthews and Z. Yi and K. Owusu-Edusei},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.03.26364601},
url = {https://www.medrxiv.org/content/10.64898/2026.10.03.26364601v1},
note = {CC BY-ND},
}
RIS
TY - UNPB
TI - The Health and Economic Impact of the Adult-specific 21-valent (aPCV21) Pneumococcal Conjugate Vaccine vs PCV20 on Invasive Pneumococcal Disease Among Adults Aged 65 years in the United Kingdom: A Modeling Study
AU - P. P. Mueller
AU - M. Simuzingili
AU - I. R. Matthews
AU - Z. Yi
AU - K. Owusu-Edusei
PY - 2026
DA - 2026/10/03
PB - medRxiv
DO - 10.64898/2026.10.03.26364601
UR - https://www.medrxiv.org/content/10.64898/2026.10.03.26364601v1
AB - IntroductionThis study compared the health and economic impact of the 21-valent pneumococcal conjugate vaccine (aPCV21) vs the 20-valent pneumococcal conjugate vaccine (PCV20) on invasive pneumococcal disease (IPD) and post-meningitis sequelae (PMS) among adults aged 65 years and older in the United Kingdom (UK). MethodsA published Markov model was used to simulate a single-cohort of vaccine-naive adults who became eligible for age-based vaccination at age 65 years, with uptake occurring over time. The cohort was followed until a maximum age of 100 years. Model inputs were derived from publicly available national health data and published reports. Outcomes were discounted at 3.5% annually, and costs were adjusted to the 2024 Great Britain Pound ({pound}). Additional analyses explored the impact of changing the age-based recommendation from 65 years to 75 years. Scenarios involving instantaneous vaccine uptake rates were included as part of the sensitivity analyses. A deterministic sensitivity analysis was performed on the incremental direct medical costs between vaccinating with aPCV21 vs PCV20 under the age-based recommendation of 65 years. ResultsUsing an age-based recommendation of 65 years, aPCV21 led to fewer cases, deaths, and costs than PCV20. Compared with PCV20, aPCV21 averted an additional 138 IPD cases, 1 PMS case, and 22 IPD deaths, saving {pound}1.2 million in direct medical costs. Raising the age-based recommendation from 65 to 75 years and using aPCV21 (or PCV20, respectively), resulted in 120 (92) additional IPD cases, 2 (1) additional PMS case(s), 19 (14) additional IPD death(s), and an extra {pound}1.1 ({pound}0.8) million in direct medical costs. The deterministic sensitivity analysis showed that aPCV21 reduced direct medical costs across all parameter ranges. ConclusionsCompared with PCV20, aPCV21 prevented more IPD cases, IPD deaths, and direct medical costs among older adults in the UK. Changing the age-based recommendation from age 65 to 75 resulted in worse health and economic outcomes.
ER -