OBJECTIVES: Pneumococcal disease remains one of the most common vaccine-preventable diseases worldwide. The introduction of pneumococcal conjugate vaccines (PCVs) such as the 13-valent PCV (PCV13) in pediatric national immunization programs (NIPs) has had a substantial impact on invasive pneumococcal disease (IPD). Recently, two higher-valent vaccines have been licensed in Europe, a 15-valent vaccine (covering PCV13 serotypes plus 22F and 33F) and a 20-valent vaccine (covering PCV15 serotypes plus 8, 10A, 11A, 12F, and 15B). The objective of this study was to evaluate the public health impact of the introduction of PCV15 or PCV20 on IPD in France.

METHODS: A decision-analytic forecasting model was adapted to compare three vaccination strategies (1) maintaining the use of PCV13, (2) switching to PCV15, and (3) switching PCV20. The model used historical age and serotype specific IPD incidence from France between 2009 and 2019 to project future IPD incidence for the entire French population over 5 years. Estimated vaccination effectiveness by serotype group was assumed to equal the observed impact of PCV13 on incidence due to PCV13-specific serotypes in France. Base-case and scenario analyses were conducted to assess different vaccine effectiveness assumptions on results.

RESULTS: Continued use of PCV13 was expected to result in 30,111 IPD cases and 4,818 IPD deaths in France over the next 5 years across all ages. Switching to PCV20 was expected to avert 3,139 IPD cases and 398 deaths compared to continued use of PCV13. Similarly, switching PCV20 was expected to avert 2,544 IPD cases and 320 deaths compared with switching to PCV15. Results of scenario analyses were consistent with base-case results.

CONCLUSIONS: Replacing PCV13 with PCV20 in the pediatric immunization program is estimated to provide greater health impact compared to PCV15 in France. PCV20 may reduce the disease burden across all ages by targeting additional serotypes not currently covered by pediatric vaccination programs.