Clinical and Economic Burden Attributable to Serotypes in Current Pneumococcal Conjugate Vaccines in Turkey

OBJECTIVES: A 13-valent pneumococcal conjugate vaccine (PCV13) has shown a great impact on pneumococcal disease (PD) since its implementation in Turkey in 2011. But the PD burdens, especially burdens associated with serotypes not covered by PCV13, still exist. With higher-valent vaccines are being available soon, the study aims to estimate annual clinical and economic burden associated with pneumococcal serotypes included in PCV13, PCV15 and PCV20 in Turkish populations aged ≤ 4 years and ≥ 65 years.

METHODS: A decision-analytic model was used to quantify annual PD cases, deaths and direct and indirect medical costs. Model inputs include incidence rates of invasive PD, pneumonia, otitis media, as well as serotype distribution, direct medical and indirect costs sourced from published literatures relevant to Turkey. Costs were inflated to 2024 values in Turkish Lira.

RESULTS: In children <1 and 1-4 years, 86,402 and 289,635 PD cases, 15 and 14 deaths and total cost (direct/indirect costs) of ₺486 million and 1.6 billion were estimated for PCV20-serotypes, respectively. For PCV13, 72,002 and 241,363 annual PD cases, 12 and 11 deaths, and ₺405 million and ₺1.3 billion costs were estimated in aged <1 and 1-4 years, respectively. No incremental burdens were estimated for PCV15 versus PCV13 in aged < 4 years. In aged ≥ 65 years, estimated annual PD cases and deaths associated with PCV20 were 69,016 and 2,055, respectively, with corresponding annual costs of ₺220 million, whereas the estimated annual PD cases and deaths for PCV13 serotypes were 55,222 and 1,462, with total cost of ₺176 million. Annual 58,357 PD cases, 1,738 deaths and ₺186 million costs were estimated for PCV15.

CONCLUSIONS: Among PCV serotypes, PCV20-serotypes account the highest clinical and economic burden across pediatric and older age groups in Turkey. Higher-valent PCVs, especially PCV20, are expected to further reduce pneumococcal disease burden in Turkey.