Introduction

Although the pneumococcal conjugate vaccine (PCV) has been introduced into select state immunization programs (SIPs) in India, many children remain unvaccinated. Recently, India’s Advisory Committee on Vaccines & Immunization Practices recommended PCV on the pediatric immunization schedule nationally. This study estimates the public health and economic impact of introducing either Pfizer’s 13-valent PCV (PCV13-PFE), GlaxoSmithKline’s 10-valent PCV (PCV10-GSK), or Serum Institute of India’s 10-valent PCV (PCV10-SII) into every pediatric SIP.

Methods

A model was developed to predict the disease cases, deaths, and costs associated with implementing PCV13-PFE, PCV10-GSK, or PCV10-SII in SIPs compared to no vaccination program across a 5-year period (2021–2025). State and national-level uptake rate and clinical and economic input parameters were collected from published literature. Disease outcomes included invasive pneumococcal disease, inpatient and outpatient pneumonia, and otitis media. Costs were estimated as vaccine-related costs and direct medical costs incurred to the healthcare system. Results were reported by individual state and aggregated nationally.

Results

Estimated over 5 years, implementing PCV13-PFE in SIPs could avert 12.1 million cases and save 626,512 lives among children under 5 years old compared to no vaccination. This corresponds to net national cost savings of over $1.0 billion. Both lower-valent PCVs are estimated to provide less economic savings than PCV13-PFE inclusive of vaccine-related costs. Compared with PCV13-PFE, implementing PCV10-GSK or PCV10-SII nationally is estimated to have a smaller public health impact, with PCV10-GSK averting 8.4 million cases (436,577 deaths) and PCV10-SII preventing 10.3 million cases (531,545 deaths) in India compared to no vaccination, respectively.

Conclusion

Implementation of PCV13-PFE throughout India is estimated to provide greater public health and economic benefits than PCV10-GSK or PCV10-SII SIPs. Our analysis highlights the substantial disease cases, deaths, and health system cost savings that may be realized from implementing PCV programs throughout India.

中文翻译：

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估计在印度的国家免疫计划中引入 13 价肺炎球菌结合疫苗或 10 价肺炎球菌结合疫苗对公共卫生和经济的影响

介绍

尽管肺炎球菌结合疫苗 (PCV) 已被引入印度的特定州免疫计划 (SIP)，但仍有许多儿童未接种疫苗。最近，印度疫苗和免疫实践咨询委员会在全国儿科免疫计划中推荐了 PCV。该研究估计了将辉瑞的 13 价 PCV (PCV13-PFE)、葛兰素史克的 10 价 PCV (PCV10-GSK) 或印度血清研究所的 10 价 PCV (PCV10-SII) 引入每个儿科 SIP。

方法

开发了一个模型来预测与在 5 年期间（2021-2025 年）中未接种疫苗计划相比，在 SIP 中实施 PCV13-PFE、PCV10-GSK 或 PCV10-SII 相关的疾病病例、死亡和成本。从已发表的文献中收集了州和国家级的摄取率以及临床和经济投入参数。疾病结果包括侵袭性肺炎球菌疾病、住院和门诊肺炎以及中耳炎。成本估计为疫苗相关成本和医疗保健系统产生的直接医疗成本。结果由个别州报告并在全国汇总。

结果

估计在 5 年内，与不接种疫苗相比，在 SIP 中实施 PCV13-PFE 可以避免 1210 万例病例并挽救 5 岁以下儿童的 626,512 条生命。这相当于节省了超过 10 亿美元的国家净成本。据估计，这两种低价 PCV 的经济节约都低于 PCV13-PFE，包括疫苗相关成本。与 PCV13-PFE 相比，估计在全国实施 PCV10-GSK 或 PCV10-SII 对公共卫生的影响较小，PCV10-GSK 避免了 840 万例病例（436,577 例死亡），PCV10-SII 预防了 1030 万例病例（531,545 例死亡）印度分别与未接种疫苗相比。

结论

据估计，在印度各地实施 PCV13-PFE 可提供比 PCV10-GSK 或 PCV10-SII SIP 更大的公共健康和经济效益。我们的分析强调了通过在整个印度实施 PCV 计划可能实现的大量疾病病例、死亡和卫生系统成本节约。