Impact of Higher-Valent Pediatric Pneumococcal Vaccines on Antimicrobial Resistant Infections and Antibiotic Prescriptions in Greece
Author(s)
Sophie Warren, MSc1, Vasiliki Kossyvaki, MD2, Marios Detsis, MS, MD2, Argyro Solakidi, MSc3.
1Pfizer, Cambridge, MA, USA, 2Pfizer, Athens, Greece, 3Pfizer Hellas, Athens, Greece.
1Pfizer, Cambridge, MA, USA, 2Pfizer, Athens, Greece, 3Pfizer Hellas, Athens, Greece.
OBJECTIVES: Antimicrobial resistance (AMR) in Streptococcus pneumoniae is a growing public health concern, driven by the emergence of resistant strains and widespread antibiotic misuse. Greece has some of the highest rates of both antibiotic consumption and AMR in Europe. Pneumococcal conjugate vaccines (PCVs) can help reduce AMR by decreasing the incidence of pneumococcal infections and consequently reducing the need for antibiotics. This analysis estimated the potential impact of pediatric use of PCV20 on antibiotic prescriptions and antibiotic-resistant pneumococcal infections compared to PCV13 and PCV15 in Greece.
METHODS: A population-based, multi-cohort, decision-analytic Markov model was adapted to estimate PCV20’s impact on antibiotic prescriptions and antibiotic-resistant cases, using the published framework by Rozenbaum et al. (2025). The model assumed 100% of invasive pneumococcal disease and inpatient pneumonia cases received antibiotic treatment across all age groups. Antibiotics were prescribed in 80% of outpatient pneumonia cases in all age groups and 98% of otitis media (OM) cases in children. In children, 25% of invasive infections and 38.6% of non-invasive infections were assumed to be antibiotic resistant. In adults, 31% of all pneumococcal infections were assumed to be antibiotic resistant. Resistance was defined as resistance to three or more clinically relevant antibiotics used to treat pneumococcal infections.
RESULTS: Across all ages, PCV20 was estimated to avert 150,007 and 118,298 more cases of antibiotic-resistant pneumococcal disease and prevent 387,781 and 305,622 more antibiotic prescriptions over a 10-year horizon compared to PCV13 and PCV15, respectively. Compared to PCV13, PCV20 could reduce antibiotic-resistant cases and prescriptions by 7.2%. Compared to PCV15, reductions of 5.8% were estimated in resistant cases and antibiotic use.
CONCLUSIONS: Widespread pediatric use of PCV20 in Greece can reduce AMR and antibiotic consumption. PCV20 implementation has the potential to substantially enhance public health in Greece while also helping to address the growing global challenge of AMR.
METHODS: A population-based, multi-cohort, decision-analytic Markov model was adapted to estimate PCV20’s impact on antibiotic prescriptions and antibiotic-resistant cases, using the published framework by Rozenbaum et al. (2025). The model assumed 100% of invasive pneumococcal disease and inpatient pneumonia cases received antibiotic treatment across all age groups. Antibiotics were prescribed in 80% of outpatient pneumonia cases in all age groups and 98% of otitis media (OM) cases in children. In children, 25% of invasive infections and 38.6% of non-invasive infections were assumed to be antibiotic resistant. In adults, 31% of all pneumococcal infections were assumed to be antibiotic resistant. Resistance was defined as resistance to three or more clinically relevant antibiotics used to treat pneumococcal infections.
RESULTS: Across all ages, PCV20 was estimated to avert 150,007 and 118,298 more cases of antibiotic-resistant pneumococcal disease and prevent 387,781 and 305,622 more antibiotic prescriptions over a 10-year horizon compared to PCV13 and PCV15, respectively. Compared to PCV13, PCV20 could reduce antibiotic-resistant cases and prescriptions by 7.2%. Compared to PCV15, reductions of 5.8% were estimated in resistant cases and antibiotic use.
CONCLUSIONS: Widespread pediatric use of PCV20 in Greece can reduce AMR and antibiotic consumption. PCV20 implementation has the potential to substantially enhance public health in Greece while also helping to address the growing global challenge of AMR.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE532
Topic
Economic Evaluation
Topic Subcategory
Novel & Social Elements of Value
Disease
Vaccines