PCV20 Shows Significant Cost-Savings, Health Benefits Compared With Previous Vaccines

Adoption of the 20-valent pneumococcal conjugate vaccine (PCV20) has been found to exhibit greater cost-savings and clinical benefits when compared with PCV13 and PCV15, according to authors of a study published in Vaccine.¹

“After PCV implementation, Australia observed substantial reductions in invasive pneumococcal disease (IPD) incidence due to the prevention of cases caused by vaccine-type serotypes,” wrote the authors of the study. “However, the burden of pneumococcal disease has remained concerning in recent years due to serotype replacement and the consequent increase in cases caused by non-PCV13 serotypes.”

Despite PCV offerings expanding significantly throughout the 21st century, experts continue to highlight a need for further development of PCVs with higher valencies. Indeed, PCV7 was the first of its kind, available for patients in the US in 2000.² Since then, PCV13, 15, 20, and 21 have all become available for protecting patients against pneumococcal diseases in the US.³

READ MORE: IPD Serotypes Decreased Significantly During the COVID-19 Pandemic

Although these vaccine options have been available to patients across the world for several years, IPD rates still soared dramatically from 2012 to 2024 and nearly doubled. With experts crediting this rise to the shifting epidemiology of nonvaccine serotypes, the PCVs currently available do not account for certain disease bacteria.

Regardless of the continuous vaccine development and close monitoring of pneumococcal serotypes, IPD cases are on the rise, and valencies beyond PCV20 and 21 are seemingly necessary or will be in the future.⁴

“While the Pharmaceutical Benefits Advisory Committee has recommended PCV13, PCV15, and PCV20 for use, only PCV20 has been included in the pediatric national immunization program (NIP) from September 2025, whereas PCV15 remained unfunded,” they continued.¹ “Our cost-effectiveness analysis aimed to compare the public health impact and economic impact of PCV20 versus PCV13 (the current standard of care [SoC]) and PCV15, all under a 2 + 1 schedule, in the Australian pediatric NIP.”

Researchers may be calling for more PCV developments, but they are also working to better understand the effects of previous PCV implementations. In this study, researchers conducted a cost-effectiveness analysis to understand the direct effects of vaccination for children under 2 living in Australia.

Using a population-based, multicohort model, researchers simulated the cost-effectiveness over a 10-year period for PCV20 against PCVs 13 and 15. The model called researchers to input data for serotype epidemiology and vaccine costs as well as both direct and indirect efficacy outcomes for the PCV itself.

Ultimately, the researchers wanted to know whether or not the effects and costs of PCV20 lead to better patient outcomes when compared with previous formulations of the vaccine.

“The model predicted that PCV20 would be dominant versus both lower-valent alternatives, averting more pneumococcal disease cases and deaths while providing substantial cost-savings among the Australian population,” the authors wrote.¹ “The conclusions drawn from this study are consistent with a growing body of evidence from economic evaluations and public health impact assessments conducted globally, all indicating the superiority of PCV20 over lower-valent alternatives.”

Yet again, researchers have uncovered further needs to develop greater valencies among PCVs. Indeed, after data input, PCV20 was estimated to reduce pneumococcal disease cases by 642,804 and deaths by 8308 when compared with PCV13. PCV20 also outperformed PCV15, reducing disease cases by 290,942 and deaths by 3730 when matched up with PCV15.

When adding in costs and discounts for receiving PCV20 compared with either previous vaccine, PCV20 continued to exhibit its dominance. The researchers’ sensitivity analysis found that “PCV20 was dominant in 97.4% and 85.7% of 1000 iterations versus PCV13 and PCV15, respectively, suggesting robust base-case results.”¹

As researchers of the study—as well as previous researchers and experts that have come before them—have mentioned, the higher-valent PCVs continue to show superiority across health care compared with their predecessors. While more evidence is released supporting further PCV development and a need for improving efficacy, cost is also a crucial factor. And if newer immunizations are cost-effective for patients, they will gravitate more toward those rather than vaccines that may be less accessible.

Until those developments are seen through to fruition, researchers of the current study suggest PCV20 as the premier option within Australia’s pediatric NIP.¹

“The findings of this analysis could support Australian policymakers in their decision-making process by providing data relating to health benefits and associated costs for different PCV options for potential implementation into the pediatric NIP,” they concluded. “As PCV20 is already approved for use in Australia, this analysis supports the preferential recommendation of PCV20 over lower-valent alternatives in Australia's pediatric NIP.”

READ MORE: Pneumococcal Resource Center

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REFERENCES

1. Struwig VA, Ta A, Thorat AV, et al. Evaluating the implementation of the 20-valent pneumococcal conjugate vaccine for paediatric immunization in Australia. Vaccine. 2025;69:127996. https://doi.org/10.1016/j.vaccine.2025.127996

2. Progress in introduction of pneumococcal conjugate vaccine --- worldwide, 2000--2008. CDC. October 24, 2008. Accessed November 17, 2025. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5742a2.htm

3. Nowosielski B. Rise in IPD calls for development of more pneumococcal vaccines. Drug Topics. November 17, 2025. Accessed November 25, 2025. https://www.drugtopics.com/view/rise-in-ipd-calls-for-development-of-more-pneumococcal-vaccines

4. Wulffraat MT, van de Weijer NG, Wijmenga-Monsuur AJ, et al. Evolving pneumococcal epidemiology and vaccine impact in the Netherlands, 2004–2024: carriage and invasive disease. J Infect. November 13, 2025:106658. https://doi.org/10.1016/j.jinf.2025.106658