OBJECTIVES: Brazil's national immunization program does not currently include a universal pneumococcal vaccination program for older adults. V116, a novel pneumococcal conjugate vaccine (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 pneumococcal vaccine. Recent 2021-2023 reports from the Brazilian invasive pneumococcal disease (IPD) surveillance indicate that serotypes included in V116 cover approximately 70.3% of IPD cases in individuals aged 60+. The 8 unique serotypes within V116 cover approximately 13.3%. This study estimates the potential health and economic impact of vaccination with V116 vs. PCV20 on pneumococcal disease in adults aged 60+ in Brazil.

METHODS: A Markov model was built to estimate the lifetime IPD, post meningitis sequelae (PMS) and non-bacteremia pneumococcal disease (NBPP) cases and the related deaths, and the associated direct medical costs in adults 60+ vaccinated with V116 or PCV20. NBPP serotype distribution is assumed to be the same as for IPD. The same serotype specific vaccine effectiveness and vaccine coverage rates (60%) were assumed for both vaccines. Epidemiological and cost data were obtained from literature and national databases. Costs were discounted at 5.0% annually and undiscounted clinical outcomes were reported.

RESULTS: In adults aged 60+, compared to no vaccination, V116 prevented 8,536 IPD cases, 325 PMS cases, 3,625 IPD deaths, 98,271 inpatient (IP) and 23,137 outpatient (OP) NBPP cases, and 18,465 NBPP-related IP deaths. PCV20 prevented 7,939 IPD cases, 302 PMS cases, 3,370 IPD deaths, 91,420 IP and 21,524 OP NBPP cases, and 17,178 NBPP-related IP deaths. The averted cases by V116 saved R$191 million in total direct medical costs, 8% more than the R$178 million averted by PCV20.

CONCLUSIONS: Comparing with PCV20, V116 led to a greater reduction of both the health and economic burden associated with pneumococcal disease in Brazil 60+ population.