1427. A dynamic modelling study of the effect of introducing a new higher valent pneumococcal conjugate vaccine in a paediatric population in the United States
Session: Poster Abstract Session: Pneumococcal Vaccines
Friday, October 5, 2018
Room: S Poster Hall
Background:

Routine use of pneumococcal conjugate vaccines (PCVs) in young children has substantially reduced vaccine-type invasive pneumococcal disease (IPD) in the US and Europe. However, increases in disease and colonization caused by non-vaccine serotypes have been observed, suggesting the need for new PCVs with broader serotype coverage. The aim of this study is to estimate the population-level impact of new PCVs to replace the existing 13-valent vaccine (PCV13) in infants.

Methods:

An age-structured dynamic transmission model of Streptococcus pneumoniae before and after PCVs introduction was developed. The model was fit to longitudinal Active Bacterial Core surveillance (ABCs) data (1997-2015) in the US on distribution and cases of IPD, as well as population level prevalence and serotype distribution data. It was assumed that total S. pneumoniae carriage remains constant over time, with full carriage replacement within four years of introduction of any PCV. Two alternative new PCVs with differing IPD coverage are tested with an introduction date of 2024.

Results:

When compared to continuing vaccination of infants with PCV13, 10 years after a new PCV is introduced (2034) cases of IPD are substantially reduced (shown in the table below). Broader serotype coverage leads to greater reductions in IPD. The greatest IPD reduction occurs in the directly vaccinated infant groups, however similar reductions are also observed in the unvaccinated elderly population due to herd protection.

Additional vaccine coverage

over PCV13 (2016/2024)*

IPD Incidence Rate Reduction [%] (2024 v. 2034)

<2 years

2-5 years

50-64 years

≥65 years

All ages

11-21%/32-35%

36%

35%

33%

31%

31%

15-30%/42-45%

42%

42%

41%

39%

40%

*Defined as the proportion of IPD cases that are caused by serotypes covered by the new PCV in 2016/2024 (a range of values is given because of differences by age group; values differ between 2016 and 2024 as serotype prevalence has not reached steady state as of 2016).

Conclusion:

A new, higher valent PCV given to infants in the US has the potential to reduce future cases of IPD. Vaccination of infants may also have a substantial indirect benefit on IPD cases in adults and the elderly.

Matthew Madin-Warburton, MSc, IQVIA, London, United Kingdom, Ashley B. Pitcher, PhD, IQVIA, Copenhagen, Denmark, Moe H. Kyaw, PhD, Sanofi Pasteur, Swiftwater, PA and Alexia Kieffer, PhD, Sanofi Pasteur, Lyon, France

Disclosures:

M. Madin-Warburton, Sanofi Pasteur: Consultant , IQVIA received consultancy fee .

A. B. Pitcher, Sanofi Pasteur: Consultant , IQVIA received consultancy fee .

M. H. Kyaw, Sanofi Pasteur: Employee , Salary .

A. Kieffer, Sanofi Pasteur: Employee , Salary .

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