Vaccine: X最新文献

{"title":"The projected cost-effectiveness and budget impact of alternative HPV vaccines in Senegal: A modeling study","authors":"Oumaima Laraj ,&nbsp;Maryam Diarra ,&nbsp;Cheikh Talla ,&nbsp;Rokhaya Diop ,&nbsp;Ousseynou Badiane ,&nbsp;Karell Pelle ,&nbsp;Amira Kebir ,&nbsp;Slimane BenMiled ,&nbsp;Cheikh Loucoubar","doi":"10.1016/j.jvacx.2026.100792","DOIUrl":"10.1016/j.jvacx.2026.100792","url":null,"abstract":"<div><h3>Background:</h3><div>Cervical cancer remains a leading cause of morbidity and mortality among women in Senegal. In 2018, with support from Gavi, Senegal introduced HPV vaccination into its immunization program using a two-dose Gardasil-4 schedule for 9-year-old girls. As Senegal approaches transition from Gavi support, full vaccine procurement costs will shift to the government, necessitating evidence-based decisions on the most cost-effective vaccination strategies. This study evaluates the health and economic value of alternative HPV vaccination options to inform sustainable and equitable policy.</div></div><div><h3>Methods:</h3><div>A static cohort model assessed the cost-effectiveness and budget impact of 23 HPV vaccination strategies varying by vaccine type (Gardasil-4, Gardasil-9, Cervarix, Cecolin), dose number (one versus two), and coverage level (current, 70%, WHO target). Health and cost outcomes were simulated for 9-year-old girls vaccinated annually from 2019 to 2034. Outcomes included cervical cancer cases, deaths, and DALYs averted. Costs were evaluated from a government perspective in 2022 USD, applying a 3% discount rate. Input parameters were from GLOBOCAN 2020, literature, and national data. Sensitivity analyses explored uncertainty around key assumptions.</div></div><div><h3>Results:</h3><div>All HPV vaccination strategies were cost-effective under a willingness-to-pay threshold of 30% of GDP per capita (USD 450 per DALY averted). Cecolin-based strategies, particularly one-dose schedules with expanded coverage, yielded the most favorable cost-effectiveness ratios. Gardasil-9 offered the greatest health benefits (up to 112,866 DALYs averted) but required higher programmatic investments, limiting cost-effectiveness unless prices decreased. Five strategies, mainly Cecolin and one-dose Gardasil-9, were efficient under national thresholds. At lower thresholds, such as 7% of GDP per capita (USD 100), one-dose Cecolin with 90% coverage was optimal.</div></div><div><h3>Conclusion:</h3><div>HPV vaccination in Senegal is highly cost-effective. Cecolin one-dose strategies offer a scalable, affordable approach post-Gavi transition, while Gardasil-9 is viable only with price reductions. Aligning vaccine choice with cost-effectiveness and feasibility is essential for long-term sustainability and equitable health outcomes.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100792"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147421634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptation of electrospinning and electrospraying for the development of novel live virus vaccine formulations","authors":"Edit Hirsch ,&nbsp;Bettina Fazekas ,&nbsp;Orsolya Péterfi ,&nbsp;Lajos Madarász ,&nbsp;György Marosi ,&nbsp;Csenge Hanna Tolnai ,&nbsp;Petra Forgách ,&nbsp;András Marosi","doi":"10.1016/j.jvacx.2026.100793","DOIUrl":"10.1016/j.jvacx.2026.100793","url":null,"abstract":"<div><div>Despite a growing interest in alternative vaccination routes, there are challenges in formulation that limit efficiency of oral or pulmonary vaccines, especially in livestock animals. Electrospinning (ES) and electrospraying offer gentle drying at room temperature, making them suitable for the formulation of biopharmaceuticals, including live virus particles. In this study, first a polyvinyl pirrolydone (PVPVA64)-based matrix system was developed and evaluated for product morphology and downstream processability to adapt the technology for virus carriage. The optimal concentration of the aqueous polymer solution was 45% for oral administration (resulting in nanofibers), and 30% for aerogenic delivery (producing nanoparticles). An automated AI tool, based on machine vision, was established for the control of particle size distribution. The study continued with the integration of three different (enveloped and non-enveloped) viruses into electrospun nanofibers, using a high-speed ES setup. PVPVA64 and polyvinyl alcohol with polyethylene oxide (PVA-PEO) were chosen as biocompatible matrix polymers, supplemented with mannitol or sucrose excipients. After optimization of the environmental conditions, changes of viral infectious titers upon production and storage were analyzed, comparing the different polymer-stabilizer combinations used. While notable variance was detected between the results of different viruses, sucrose was overall more effective in the protection of viral infectivity at the initial stage (the ES process), while mannitol had a superior protective effect during later storage. PVPVA64 supplemented with mannitol was the best combination regarding all-round stability of virus-loaded nanofibers. Using the same matrix (PVPVA64-mannitol), electrosprayed nanoparticles were also constructed to encapsulate the porcine coronavirus TGEV, where viral titers showed even higher long-term stability than in nanofibers. Our results prove the high potential of ES and electrospraying for the dry formulation of viruses. With further research, these technologies might open up new possibilities in vaccination against viral diseases of animals and humans.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100793"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparturient sow vaccination with a rIdeSsuis derivative: Immunogenicity and protective efficacy against Streptococcus suis serotype 14","authors":"Carolin Liedel ,&nbsp;Leonie Mayer ,&nbsp;Christine Weiße ,&nbsp;Haukur L. Sigmarsson ,&nbsp;Iris Völker ,&nbsp;Christoph G. Baums ,&nbsp;Karoline Rieckmann","doi":"10.1016/j.jvacx.2026.100794","DOIUrl":"10.1016/j.jvacx.2026.100794","url":null,"abstract":"<div><div><em>Streptococcus (S.) suis</em> is an important causative agent of arthritis, meningitis and septicemia affecting pigs of different age groups, including suckling piglets. Accordingly, early protection of piglets against this pathogen is highly relevant. Vaccination of piglets with the recombinant IgM degrading enzyme of <em>S. suis</em>, Ide_{<em>Ssuis</em>}, confers protection against mortality in weaning piglets experimentally challenged with serotypes (<em>cps</em>) 2 and 14 of sequence type 1 or 9 of sequence types 50 and 94. The aim of this study was to determine immunogenicity and protective efficacy in the offspring of sows prime-boost vaccinated with a recombinant variant of Ide_{<em>Ssuis</em>} formulated with the adjuvant Montanide ISA 25. Sows were vaccinated 5 and 2 weeks prior to farrowing and developed high levels of serum and colostrum α-Ide_{<em>Ssuis</em>} IgG antibodies, which were shown to neutralize the IgM cleaving activity of Ide_{<em>Ssuis</em>}. Piglets suckled by immunized sows had significantly higher specific α-Ide_{<em>Ssuis</em>} IgG antibody levels compared to control piglets until the 11th week of life. Differentiation of IgG1 and IgG2 levels revealed that α-Ide_{<em>Ssuis</em>} IgG2 levels in 2-week-old suckling piglets of vaccinated sows were comparable to respective levels of prime-boost-boost vaccinated weaning piglets using a formulation with the adjuvant Emulsigen, whereas α-Ide_{<em>Ssuis</em>} IgG1 were lower in suckling piglets. Results of the intranasal challenge experiment suggested protection against morbidity in the 4th week of life against <em>S. suis cps</em>14, in agreement with results of bactericidal assays. In conclusion, this study further confirms Ide_{<em>Ssuis</em>} as a promising antigen for vaccination of sows pre-farrowing to control <em>S. suis</em> diseases.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100794"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “AderVax: Factors related to the acceptance or rejection of the COVID-19 vaccine in 8 cities in Colombia for the development of an intervention” [Vaccine: X 28 (2026) 100767]","authors":"Laura Juliana Valderrama-Orbegozo ,&nbsp;Laura Julieth Ramírez-Lasprilla ,&nbsp;Diana Estefanny Arce-Leonel ,&nbsp;Michell Rezene Tesfamariam-Ortega ,&nbsp;David Javier Fortich-Pérez","doi":"10.1016/j.jvacx.2026.100788","DOIUrl":"10.1016/j.jvacx.2026.100788","url":null,"abstract":"","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100788"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of psychological factors influencing attitudes and intentions toward, and uptake of, Covid-19 vaccines in adolescents","authors":"Angie Pitt ,&nbsp;Richard Amlôt ,&nbsp;Catherine Heffernan ,&nbsp;G. James Rubin ,&nbsp;Louise E. Smith","doi":"10.1016/j.jvacx.2026.100785","DOIUrl":"10.1016/j.jvacx.2026.100785","url":null,"abstract":"<div><div>Vaccination was a key measure to tackle the Covid-19 pandemic, however adolescents were less likely than adults to accept the vaccine. Low vaccine uptake reduces the effectiveness of vaccination campaigns and threatens global public health. Understanding why adolescents are hesitant to accept new vaccines is therefore crucial to support the development of novel vaccine uptake interventions. Prior reviews have included far fewer citations, excluded qualitative data orstudies after 2022 and have not mapped adolescent Covid-19 vaccine behaviour onto psychological models. This systematic review investigated psychological factors influencing attitudes and intentions toward and uptake of Covid-19 vaccines in adolescents aged 10 to 19 years globally. It mapped results onto the COM-B framework to inform future interventions. Our search identified 25,354 citations, and included 77 in this review. The quality of studies was mixed, predominantly cross-sectional in design. According to our review, key influences on adolescent Covid-19 vaccine behaviour were: i) Reflective motivation (safety concerns, perceived susceptibility to/severity of Covid-19, perceived vaccine effectiveness, ii) Social opportunity (social norms, autonomy and prosocial attitudes), iii) Psychological capability (attitude and knowledge about vaccines). Our review provides new insights into psychological factors influencing adolescent Covid-19 vaccine behaviour, and maps factors to the COM-B model of behaviour change. To improve vaccine uptake, future vaccine interventions should support adolescents to think critically about the pros and cons of vaccines and consider external influences on their decisions.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100785"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal survey of 6-monthly booster vaccination-induced antibody responses to equine influenza A virus (H3N8) in Standardbred trotting horses in training","authors":"Eva Wattrang ,&nbsp;Helena Back ,&nbsp;Louise Treiberg Berndtsson ,&nbsp;Siamak Zohari ,&nbsp;Janet Daly","doi":"10.1016/j.jvacx.2026.100778","DOIUrl":"10.1016/j.jvacx.2026.100778","url":null,"abstract":"<div><div>Vaccination is an established and important tool in preventing the impact of influenza in the horse population but the frequency of booster vaccinations after the primary course of vaccinations to maintain protective antibody levels is still under debate. The aim of this field study was to monitor equine influenza antibody levels over the course of 13 months during which horses were given two booster vaccinations.</div><div>Fifty-six vaccinated Standardbred trotters in training were monitored with monthly blood samples. The horses were routinely vaccinated with a commercial equine influenza vaccine 6 months apart, V1 and V2. Antibodies to vaccine strain A/equine/Borlänge/91 (Bor/91) were quantified by ELISA in all samples and also measured by single radial haemolysis (SRH) in samples obtained before and after V1.</div><div>Mean titres against Bor/91 determined by ELISA were at the lowest level in the month prior to V1. All horses sampled immediately before and after V1 had an increase in titre except two ≥ 4-year-old horses. The antibody titres declined rapidly in the 3 months after V1. The boosting effect of V2 was lower compared to that of V1 and six horses with high pre-vaccination titres did not respond to V2, irrespective of age. Titres estimated by ELISA correlated well with antibody levels determined by SRH, which showed that while many of the horses would be unprotected before V1, antibody levels were boosted to protective levels after vaccination.</div><div>Antibody responses were higher in horses with low antibody levels at booster vaccination compared to those with already high antibody levels.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100778"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of seasonal influenza vaccine hesitancy among young adults at a Hong Kong university before and after the start of the COVID-19 pandemic: A repeated cross-sectional study","authors":"Hongsen Liang ,&nbsp;Fatema Khairunnasa ,&nbsp;Hsiang-Yu Yuan","doi":"10.1016/j.jvacx.2025.100774","DOIUrl":"10.1016/j.jvacx.2025.100774","url":null,"abstract":"<div><h3>Background</h3><div>Vaccine hesitancy (VH) among young adults limited seasonal influenza vaccine (SIV) uptake in Hong Kong. The impact of the COVID-19 pandemic on this issue remains unclear.</div></div><div><h3>Methods</h3><div>A repeated cross-sectional study was performed on 269 young adults aged 18 to 35 at a Hong Kong university during two seasons: pre-COVID-19 (September 30, 2019, to April 1, 2020, with 130 participants) and during-COVID-19 (March 29, 2021, to May 2, 2021, with 139 participants). We developed our questionnaire based on the Health Belief Model (HBM) and included peer influence. The best-fitting logistic regression model, selected using the chi-square test and Akaike Information Criterion (AIC), was used to assess the association between selected factors and VH in both periods.</div></div><div><h3>Results</h3><div>From the pre- to during-COVID-19 pandemic, the proportion of participants exhibiting vaccine hesitancy increased from 43.8 % to 62.6 %. Perceived vaccine side effects, vaccine efficacy, and peers' vaccination status became significant with odds ratios of 3.941 (95 % Confidence Interval (CI) [1.27, 14.36]), 0.1344 (95 % CI [0.02, 0.56]), and 0.1147 (95 % CI [0.02, 0.52]), respectively.</div></div><div><h3>Conclusions</h3><div>A comprehensive approach that includes effective communication about vaccine safety and efficacy is crucial. Additionally, the vaccination status of peers may play an important role in vaccine promotion among young adults in Hong Kong.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100774"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to pneumococcal vaccination in rural community pharmacy: A qualitative study","authors":"Leticia E.B. Vieira ,&nbsp;Grace T. Marley ,&nbsp;Tessa J. Hastings ,&nbsp;Salisa C. Westrick ,&nbsp;Ashley H. Chinchilla ,&nbsp;Tyler C. Melton ,&nbsp;Delesha M. Carpenter","doi":"10.1016/j.jvacx.2026.100786","DOIUrl":"10.1016/j.jvacx.2026.100786","url":null,"abstract":"<div><h3>Background</h3><div>Inadequate pneumococcal vaccine uptake in rural U.S. communities remains a significant barrier to effective pneumococcal disease prevention. Community pharmacists are well-positioned to expand vaccine coverage by offering and administering pneumococcal vaccines, but face unique challenges in rural pharmacy settings.</div></div><div><h3>Objective</h3><div>To explore pharmacist-reported barriers and facilitators to pneumococcal vaccination in rural community pharmacies.</div></div><div><h3>Methods</h3><div>Qualitative interviews were conducted with twenty rural pharmacists from a practice-based research network (a collaborative group of community pharmacies engaged in applied research to improve pharmacy practice) across seven U.S. states. Pharmacists were purposefully sampled based on their state and the number of pneumococcal vaccines administered at their pharmacy in the previous year. Interviews assessed factors influencing pneumococcal vaccination across levels of the Social Ecological Framework. Interviews continued until thematic saturation was reached, and iterative thematic analysis of de-identified interview transcripts was conducted until no new themes emerged.</div></div><div><h3>Results</h3><div>Barriers and facilitators to pneumococcal vaccination were identified across all socioecological levels. At the individual level, themes included pharmacists' attitudes, training, and rapport with patients, as well as patients' attitudes, knowledge, and out-of-pocket costs. At the organizational level, themes were related to the pharmacy workflow, staff, time constraints, immunization area, and vaccine stocking costs. Community-level themes involved local physicians, social influences, and factors specific to rural areas. Policy-level themes encompassed vaccination guidelines, states' immunization registries, reimbursement, and immunization regulations.</div></div><div><h3>Conclusion</h3><div>Pneumococcal vaccination in rural community pharmacies is influenced by multilevel factors, including individual, organizational, community, and policy factors. Effective interventions will require training initiatives for pharmacists, resources to improve patients' vaccine knowledge and attitudes, organizational strategies to streamline immunization workflow, and policy changes to advance pharmacy-based immunization services that account for rural community needs.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100786"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising HPV vaccination delivery in Tasmanian schools (Australia): Lessons from parents and providers","authors":"Maria Unwin ,&nbsp;Alison Venn ,&nbsp;Cassandra Vujovich-Dunn ,&nbsp;Nicola Stephens ,&nbsp;Kerry Nettle ,&nbsp;Mark Veitch ,&nbsp;Rebecca Guy ,&nbsp;Cristyn Davies","doi":"10.1016/j.jvacx.2026.100790","DOIUrl":"10.1016/j.jvacx.2026.100790","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite having well-established relationships and processes for the school-based immunisation program (SBIP), Tasmania has sub-optimal HPV vaccine completion. The HPV Vaccination Partnership Project aimed to understand facilitators and barriers to students' initiation and completion of vaccination in Tasmanian schools.</div></div><div><h3>Methods</h3><div>In this qualitative study, semi-structured interviews were undertaken with school personnel, council (local government) immunisation providers and parents of HPV vaccine-eligible adolescents (2021−2023). We chose a sample of Tasmanian secondary schools across sectors, regions, and demographic variables with varying coverage levels. Council staff providing the SBIP, key school personnel involved in program delivery, and parents of adolescents with incomplete HPV vaccination status were invited to participate. Interviews explored roles and relationships across health and education sectors, parents, and adolescents; HPV vaccination information, communication, and processes; the school vaccination environment; and parents' perspectives on HPV vaccination for their adolescents. Transcripts were analysed using thematic analysis and reported using the Consolidated Criteria for Reporting qualitative research. Knowledge mobilisation principles were adopted to support research translation and dissemination.</div></div><div><h3>Results</h3><div>We recruited 18 council personnel, 15 school personnel, and 14 parents. HPV vaccination program facilitators included collaborative partnerships with clear roles between health and education sectors, proactive leadership, well-established practices and processes, a supportive vaccination environment, and clear communication and information sharing between stakeholders. Barriers included consent form return processes and complex information for parents, poor communication among stakeholders, unfamiliarity with SBIP roles and processes, and unwelcoming vaccination environments. Parents with poor experiences of school-based vaccination as adolescents, and adolescents with poor experiences of healthcare more broadly, generated unfavourable attitudes towards HPV vaccination.</div></div><div><h3>Conclusion</h3><div>Findings highlight the importance of clear strategies to promote strong relationships, define roles, ensure access to easily understood vaccine information, and to streamline consent form processes. The Tasmanian Department of Health is using study findings to inform SBIPs.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100790"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness analysis of 20-valent pneumococcal conjugate vaccine in the Portuguese paediatric national immunisation programme","authors":"Cátia Mota ,&nbsp;An Ta ,&nbsp;Elizabeth Vinand ,&nbsp;Rita Teixeira ,&nbsp;Aleksandar Ilic ,&nbsp;Sophie Warren","doi":"10.1016/j.jvacx.2026.100789","DOIUrl":"10.1016/j.jvacx.2026.100789","url":null,"abstract":"<div><h3>Background</h3><div>Since the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) for paediatric use in Portugal, pneumococcal disease incidence among children has declined. With the availability of 20-valent PCV (PCV20) and 15-valent PCV (PCV15) and the Portuguese Board of Health's decision to implement PCV20 2 + 1 into the National Immunisation Programme (NIP), the cost-effectiveness of PCV20 under 2 + 1 and 3 + 1 schedules was assessed versus PCV13 2 + 1 and PCV15 2 + 1 in Portugal.</div></div><div><h3>Methods</h3><div>Using a Portuguese National Health Service (NHS) perspective, a Markov model with annual cycles estimated health and cost impacts of PCV20 versus PCV13 and PCV15 over 10 years, with both cost and benefits discounted at 4%. Direct effects were based on PCV13 effectiveness and 7-valent PCV efficacy studies; indirect effects were sourced from PCV13 impact studies. Epidemiologic, utility, and cost inputs were from Portuguese data, where available. Sensitivity and scenario analyses tested result robustness.</div></div><div><h3>Results</h3><div>The base case showed that PCV20 2 + 1 was dominant versus both PCV13 and PCV15. PCV20 2 + 1 was estimated to avert 1884 invasive pneumococcal disease (IPD) cases, 54,768 hospitalised pneumonia cases, 222,497 otitis media (OM) cases, and 8737 deaths versus PCV13 2 + 1, resulting in a quality-adjusted life year (QALY) gain of 109,092 and cost-saving of €237,294,966. PCV20 2 + 1 averted 1653 IPD cases, 42,182 hospitalised pneumonia cases, 202,735 OM cases, and 6594 deaths versus PCV15 2 + 1, resulting in a QALY gain of 83,799 and cost-saving of €199,695,659. Pairwise comparisons of PCV20 3 + 1 versus PCV13 2 + 1 and PCV15 2 + 1, including sensitivity and scenario analyses, consistently showed cost-saving results, aligning with findings from PCV20 2 + 1 analysis.</div></div><div><h3>Conclusions</h3><div>PCV20 (both 2 + 1 and 3 + 1) was estimated to be cost saving and more effective versus PCV13 and PCV15. Switching from PCV13 to PCV20 in the Portuguese paediatric NIP could yield considerable clinical and economic benefits from NHS perspective.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100789"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}