OBJECTIVES : V114, an investigational 15-valent pneumococcal conjugate vaccine (PCV) is under development that contains all serotypes in PCV10 and PCV13 and 2 additional serotypes (22F/33F). This study quantifies the health and economic burden of invasive pneumococcal disease (IPD) associated with V114 serotypes in Finland, the Netherlands and Austria.

METHODS : A Markov model was developed to simulate V114-type IPD cases, deaths and costs in hypothetical unvaccinated birth cohorts over 20 years. All inputs were obtained from the published literature. In the pre-PCV analysis, epidemiological inputs from the pre-PCV7 era were applied to all serotypes. In the post-PCV analysis, pre-PCV7 and pre-PCV10 inputs were applied to PCV7 serotypes and PCV10 not PCV7 (PCV10-PCV7) serotypes. Disease attributable to V114 not PCV10 (V114-PCV10) serotypes were estimated using the most recent data. Costs were estimated from a societal perspective (2017 Euros) and discounted at 3%.

RESULTS : In the pre-PCV analysis, 355 V114-type IPD cases would occur: 244 (69%) attributable to PCV7 serotypes, 53 (15%) to PCV10-PCV7 serotypes, and 58 (16%) to V114-PCV10 serotypes. V114 serotypes caused 74 IPD deaths. Costs of V114-type IPD was €9.4 million.

In the post-PCV analysis, V114-type IPD increased to 406 cases: 244 (60%) attributable to PCV7 serotypes, 66 (16%) to PCV10-PCV7 serotypes, and 96 cases (24%) to V114-PCV10 serotypes. Compared to the pre-PCV analysis, the additional 13 cases attributable to PCV10-PCV7 serotypes were mainly caused by serotype 1. The additional 38 cases attributable to V114-PCV10 serotypes were from serotypes 3 (33 cases, 91%) and 19A (11 cases, 31%). Costs of V114-type IPD increased to €10.4 million. Deterministic sensitivity analysis will be performed.

CONCLUSIONS : PCV7 serotypes cause most IPD-related morbidity and costs and should be retained in investigational PCVs. Serotypes contained in PCV10 and PCV13 also contribute to IPD morbidity and cost. Expanding coverage to non-vaccine serotypes can prevent additional disease.