OBJECTIVES: Mexico's national immunization program includes pneumococcal vaccination for adults aged ≥60 years, offering PCV13 for healthy adults and a sequential regimen (PCV13+PPSV23) for high-risk patients. V116, a novel PCV, designed for adults, includes 8 unique serotypes (15A, 15C [from deOAc-15B], 16F, 23A, 23B, 24F, 31 and 35B) not covered by any currently licensed vaccine. From 2018-2021, serotypes included in V116 caused approximately 76% of invasive pneumococcal disease (IPD) in individuals aged 60+ in Mexico, with the 8 unique serotypes responsible for about 23%. This study estimates the potential health and economic impact of vaccination with V116 versus PCV20 in adults aged ≥60 years in Mexico.

METHODS: A Markov model was built to estimate the lifetime IPD, post-meningitis sequelae (PMS) and non-bacteremic pneumococcal pneumonia (NBPP) cases and related deaths, and the associated direct medical costs among the adults aged ≥60 years vaccinating with V116 or PCV20. The same serotype specific vaccine effectiveness and vaccine coverage rates were assumed for both vaccines. Epidemiological and cost data were obtained from literature and Mexican databases. Economic outcomes were discounted at 5.0% annually and undiscounted clinical cases were reported.

RESULTS: In adults aged ≥60 years, compared to PCV13, V116 prevented an additional 3,434 IPD cases, 93 PMS cases, and 1,841 IPD deaths, 26,838 inpatient (IP) and 10,835 outpatient (OP) NBPP cases, and 7,461 NBPP deaths. Meanwhile, the additional cases prevented by PCV20 vs. PCV13 were: 1,675 IPD cases, 45 PMS cases, and 898 IPD deaths, 13,085 IP and 5,284 OP NBPP cases, and 3,638 NBPP deaths. In terms of total direct costs, V116 and PCV20 saved an additional MXN 2.70 billion and MXN 1.32 billion, respectively, compared to PCV13.

CONCLUSIONS: Compared to PCV13, V116 demonstrated more than twice the reduction averted by PCV20 in both the health and economic burden of pneumococcal disease in older adults in Mexico.