Cost-Effectiveness of Infant Pneumococcal Conjugate Vaccination Strategies in Vietnam: A Stepwise Economic Evaluation

This peer-reviewed article, examines the cost-effectiveness of alternative infant pneumococcal conjugate vaccination strategies in Vietnam as the country considers introducing a pediatric PCV into its National Immunization Program. The study uses an adapted Markov model from a payer perspective to compare PCV10, PCV13, PCV15, and PCV20 under two scenarios: vaccination through the private market using a 3 + 1 schedule, and a hypothetical pediatric NIP using a 2 + 1 schedule. The analysis applies stepwise comparisons between each vaccine and the next higher-valent option to estimate health and economic outcomes and inform vaccine selection decisions.

Key findings

• Under the 3 + 1 private-market scenario, PCV13 was cost-effective compared with PCV10, and PCV20 was cost-effective compared with PCV15.
• Under the 2 + 1 NIP scenario, PCV13 remained cost-effective relative to PCV10, while PCV15 was not cost-effective compared with PCV13.
• In the 2 + 1 NIP scenario, PCV20 was estimated to be dominant over PCV15, meaning it generated better health outcomes at lower total cost.
• The analysis suggests that wider uptake of infant pneumococcal vaccination would produce disproportionately higher health gains and substantial direct medical cost savings.
• The paper highlights the policy relevance of vaccine choice in a setting where multiple PCVs are available but Vietnam has not yet introduced a pediatric pneumococcal vaccine into its NIP.