The Knowledge Hub

Immunization with PCV reduces pneumonia cases and saves lives, easing economic burden on families and health systems

A surveillance study over a 10-year period in the Gambia found that routine introduction of PCV led to a 33% reduction in the incidence of radiological pneumonia and a 27% decline in pneumonia hospitalizations in children. Reducing the rate of pneumococcal disease will not only save lives but will also reduce the substantial economic burden placed on families and health systems.

Mackenzie GA, Hill PC, Jeffries DJ et al.. 2021. Impact of the introduction of pneumococcal conjugate vaccination on invasive pneumococcal disease and pneumonia in The Gambia: 10 years of population-based surveillance. The Lancet Infectious Diseases. 21(9).

The introduction of PCV13 vaccine in Tennessee reduced racial disparities in pneumococcal disease

Population-based surveillance data collected in the state of Tennessee from 1998 – 2016 found that the introduction of PCV13 was associated with reductions in socioeconomic and racial disparities in PCV13-serotype invasive pneumococcal disease (IPD). PCV13 introduction was associated with the prevention of IPD in the overall population as well as substantial decreases in racial disparities in IPD over time between Black and White populations. Before PCV13 was introduced, Black people in the study had an IPD incidence 1.5 times higher than White people – 24.7 and 16.4, respectively. After PCV13 introduction, Black people had an IPD incidence 1.15 times the incidence among Whites: 15 and 13.1, respectively.

Raman R, Brennan J, Ndi D et al.. 2021. Marked Reduction of Socioeconomic and Racial Disparities in Invasive Pneumococcal Disease Associated With Conjugate Pneumococcal Vaccines. The Journal of Infectious Diseases. 223(7).

Immunization programs have saved millions of lives, especially among children, and will continue to do so in the future

Increases in vaccine coverage and the introduction of new vaccines into LMICs have had a major impact in reducing mortality. Vaccination programs for ten selected pathogens will have averted an estimated 69 million deaths in 98 low- and middle-income countries between 2000 and 2030. Most of this impact has been concentrated in a reduction in mortality among children younger than 5 years (57% reduction), most notably from measles. These public health gains are predicted to increase in coming decades if progress in increasing vaccine coverage is sustained.

Li X, Mukandavire C, Cucunubá ZM et al.. 2021. Estimating the health impact of vaccination against ten pathogens in 98 low-income and middle-income countries from 2000 to 2030: a modelling study. The Lancet. 397(10272).

Introduction of PCV10 reduced antimicrobial use for acute otitis media, saving healthcare costs and combating antimicrobial resistance

The 2010 introduction of PCV10 for infants in Finland led to an estimated 15% reduction among unvaccinated children in purchases of antimicrobials recommended for acute otitis media (AOM), the most common reason for antimicrobial use in many countries. The indirect effects of PCV10 introduction contribute to health care savings and may also help to combat antimicrobial resistance.

Palmu AA, Rinta-Kokko H, Nohynek H et al.. 2020. Indirect Impact of Ten-valent Pneumococcal Conjugate Vaccine Program on Reducing Antimicrobial Use and Tympanostomy Tube Placements in Finland. The Pediatric Infectious Disease Journal. 39(9).

Immunization against influenza and pneumococcus can reduce healthcare visits and antibiotic use, improving overall health

This systematic review suggests that vaccination against influenza and pneumococcus can reduce overall healthcare visits and antimicrobial consumption. Of the 26 studies included in the review, 23 found significant reductions in antimicrobial use in vaccinated individuals or groups. This evidence indicates that improved coverage with existing vaccines may significantly reduce antimicrobial demand.

Doherty TM, Hausdorff WP, Kristinsson KG. 2020. Effect of vaccination on the use of antimicrobial agents: a systematic literature review. Annals of Medicine. 52(6).

Immunization with pneumococcal and rotavirus vaccines can prevent millions of episodes of treatment with antibiotics

In this analysis of data from large-scale studies of households, two vaccines recently implemented in the WHO EPI, pneumococcal conjugate vaccines and live attenuated rotavirus vaccines, were estimated to confer 20% and 11% protection against antibiotic-treated episodes of acute respiratory infection and diarrhea, respectively, in the age groups with the greatest disease burden attributable to these pathogens. Under current coverage levels, pneumococcal and rotavirus vaccines are estimated to prevent 24 million and 14 million episodes, respectively, of antibiotic-treated illness each year among children in LMICs less than five years old. An additional 40 million episodes could be prevented through achievement of universal coverage targets.

Lewnard JA, Lo NC, Arinaminpathy N et al.. 2020. Childhood vaccines and antibiotic use in low- and middle-income countries. Nature. 581.

Immunizing infants with pneumococcal vaccines saves billions of dollars in treatment and societal costs worldwide

Vaccination of infants with pneumococcal conjugate vaccines in 180, from the health system perspective, would save an estimated $3.2 billion per year worldwide in treatment costs and an additional $2.6 billion in societal costs (from reduced missed work and out-of-pocket expenditures)- for a total of $5.8 billion. These savings would partially offset the estimated global cost of vaccination of $15.5 billion per year.

The cost estimates were calculated in international dollars.

Chen C, Liceras FC, Flasche S et al.. 2019. Effect and cost-effectiveness of pneumococcal conjugate vaccination: a global modelling analysis. Lancet Global Health. 7(1).

Pneumococcal conjugate vaccines are cost-effective in low income regions and can save lives globally

In an analysis of the impact and cost-effectiveness of pneumococcal conjugate vaccines (PCV) in preventing disease and deaths in children under five years in 180 countries, the vaccination was most cost-effective in low income regions and Gavi-eligible countries. The average cost per disability adjusted life year (DALY) was $118 in Africa, $853 in Asia, and $16,000 in Europe. PCV introduction throughout Africa would account for nearly 70% of lives saved globally, but requires only 12% of the global investment.

The cost estimates were calculated in international dollars.

Chen C, Liceras FC, Flasche S et al.. 2019. Effect and cost-effectiveness of pneumococcal conjugate vaccination: a global modelling analysis. Lancet Global Health. 7(1).

Introducing the PCV vaccine in India will save millions of dollars in healthcare costs, especially for the poorest households

An analysis of the potential impact of pneumococcal conjugate vaccine (PCV) in India found that introducing PCV vaccine will protect the population from potentially catastrophic health expenditures due to treatment and hospitalizations for pneumococcal disease – saving an estimated $49-63 million in out-of-pocket expenditures each year, depending on the assumed vaccination coverage rate. Financial protection will be greatest for the poorest households, with the poorest quintile is estimated to have the greatest savings in out-of-pocket expenditures of all wealth quintiles.

Megiddo I, Klein E, Laxminarayan R. 2018. Potential impact of introducing the pneumococcal conjugate vaccine into national immunisation programmes: an economic epidemiological analysis using data from India. BMJ Global Health. 3(3).

Immunizing with pneumococcal conjugate vaccine in India can greatly reduce deaths, especially among the poor

A modeled analysis of the potential impact of pneumococcal conjugate vaccine (PCV) in India estimated that the greatest reductions in deaths due to PCV vaccination would be among the poorest segments of the population. Assuming a vaccination coverage rate of 77% (the current DTP3 coverage rate), PCV would prevent nearly 2.5 times as many deaths per 100,000 children under five in the 2 poorest income quintiles than in the 2 wealthiest groups (313 vs. 134), and nearly 3 times as many deaths per 100,000 if coverage reaches 90% (446 vs. 167).

The model used was specific to the epidemiology, health system situation, and population characteristics of India.

Megiddo I, Klein E, Laxminarayan R. 2018. Potential impact of introducing the pneumococcal conjugate vaccine into national immunisation programmes: an economic epidemiological analysis using data from India. BMJ Global Health. 3(3).