Overview of Technical Review Summary
Reviewing Body: Committee on Vaccine Evaluation, Subcommittee on Basic Vaccination Policy, Immunization and Vaccines Subcommittee, Council for Science and Technology on Health (30th Meeting, July 4, Reiwa 7)
Subject: Introduction of 15-valent (PCV15) and 20-valent (PCV20) pneumococcal conjugate vaccines for elderly regular immunization
Key Evidence Assessment
Disease Burden
IPD (Invasive Pneumococcal Disease) and Pneumococcal Pneumonia: High disease burden among elderly population; prevention is critically important for public health
Serotype Coverage: PCV20 and 23-valent polysaccharide vaccine (PPSV23) cover higher proportion of serotypes compared to PCV15
Indirect Effects: Confirmed indirect benefits to elderly from pediatric PCV vaccination; however, no reports of indirect effects between adults
Vaccine Efficacy
PCV15・PCV20: No direct clinical efficacy data currently available, but confirmed non-inferiority or sufficient immune response compared to PCV13
PCV13 Extrapolation: Application of PCV13 evidence to IPD and pneumococcal infections covered by same serotypes is appropriate
Duration: PCV13 effectiveness persists for at least 4-5 years; efficacy decreases with advancing age
Cost-Effectiveness Analysis
Age 65 Vaccination: PCV20 shows best cost-effectiveness compared to current PPSV23; PCV15 and PCV15-PPSV23 sequential vaccination also favorable
Age-Related Effects: Cost-effectiveness favorable at ages 65 and 70; deteriorates at ages 75 and 80
Conclusions and Recommendations
Vaccine Change
Recommendation: Changing regular immunization vaccine from PPSV23 to PCV20 is appropriate
Vaccination Age
Current System Maintained: Vaccination at age 65 remains appropriate System Consideration: Age 70 vaccination also shows favorable cost-effectiveness including those with prior PPSV23 vaccination; institutional review of target age ranges needed
Future Deliberations
Based on this technical summary, vaccines used in regular immunization and target age ranges should continue to be deliberated by the Basic Vaccination Policy Subcommittee and related bodies.