https://orcid.org/0000-0001-6307-6916
We thank Feemster KA and colleagues [Citation1] for their interest in our manuscript, Cost-effectiveness analysis for PCV13 in adults 60 years and over with underlying medical conditions which put them at an elevated risk of pneumococcal disease in Japan.
The letter addresses the parameter values on vaccine efficacy (VE) and duration of immunity for PPSV23.
Regarding the VE for PPSV23, it is noteworthy that the authors of the letter have focused their comments on Invasive Pneumococcal Disease and not on Pneumococcal Pneumonia. They will know that the cost-effectiveness of pneumococcal vaccination programs is primarily and almost exclusively driven by the effectiveness of the pneumococcal vaccine against pneumococcal pneumonia. It is therefore very interesting that the authors made no reference to these parameter values in our cost-effectiveness analysis. It should be noted that in our efforts to ensure scientific balance in our analysis we used in our base case the findings of Suzuki M et al. on the effectiveness and duration of protection of Pneumovax® (PPSV23) against pneumococcal pneumonia [33.5% (5.6 to 53.1)] [Citation2] instead of the more recent analysis by Kim JH et al. [10.2% (−15.1–30.6)] [Citation3] or Heo JY et al. [11.0% (−26.4% to 37.3%)] [Citation4]. Further, in our analysis, we focused on data generated in Japan as serotype distribution, clinical practice, and research methods in Japan are most relevant for decision-making in Japan.
Regarding the duration of immunity, our analysis used the assumptions used by the National Institute for Infectious Diseases (NIID) used for the Pneumococcal Vaccines ‘Fact Sheet’ of 2018 [Citation5]. Of great concern, however, is the suggestion by the authors that they do not recognize the profound scientific credibility of NIID as they raise questions on the results of the analysis done by this institution. Further, various authors in many countries have recognized and communicated on the need for re-vaccination after 5 years acknowledging the limited protection associated with PPSV23 [Citation6–8].
There is always uncertainty in the assumptions of the parameter values in the model. Therefore, we conducted various sensitivity and scenario analyses with meaningful settings in Japan.
Declaration of interest
A Igarashi has disclosed that he received a consultant fee from Pfizer Japan, Inc., in connection with the conduct of this study. In addition, he has disclosed that he received grants from Taiho Pharmaceutical Co. Ltd., grants and other from Gilead Sciences KK., grants from Intuitive Surgical GK., grants from Boston Scientific Japan Inc., grants and personal fees from Pfizer Japan Inc., grants from Becton Dickinson and Company, grants from Milliman Inc., personal fees and other from Terumo corporation, personal fees from Chugai Pharmaceuticals Inc., personal fees from Astellas Pharma Inc., other from Fuji film Inc., other from CSL Behring Japan Inc., personal fees from Sanofi Japan Inc., personal fees and other from Takeda Pharmaceutical Inc., personal fees from Nippon Boehringer Ingelheim Inc., personal fees from Ono pharmaceutical Inc., personal fees from Novartis Pharma Japan Inc., personal fees from Eisai Inc., personal fees from AbbVie GK, personal fees from Sumitomo Dainippon Pharma Inc., personal fees from Ayumi Pharmaceutical Inc., personal fees from Medilead Inc., personal fees from Novo Nordisk Japan Inc., personal fees from GSK Japan Inc., outside the submitted work. E Hirose, Y Kobayashi, N Yonemoto and B Lee have disclosed that they are employees of Pfizer Japan Inc. and stockholders of Pfizer Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
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References
- Feemster KA, Kim Y, Abe M, et al., Response to Igarashi, et al. Cost-effectiveness analysis for PCV13 in adults 60 years and over with underlying medical conditions which put them at an elevated risk of pneumococcal disease in Japan. Exp Rev Vaccines 2021;21(5):1–2. DOI: https://doi.org/10.1080/14760584.2022.2036127
- Suzuki M, Dhoubhadel BG, Ishifuji T, et al. Serotype-specific effectiveness of 23-valent pneumococcal polysaccharide vaccine against pneumococcal pneumonia in adults aged 65 years or older: a multicentre, prospective, test-negative design study. Lancet Infect Dis. 2017;17(3):313–321.
- Kim JH, Chun BC, Song JY, et al. Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: a case-control study. Vaccine. 2019 May 9;37(21):2797–2804.
- Heo JY, Seo, YB, Choi, WS, et al. Effectiveness of pneumococcal vaccination against hospitalized pneumococcal pneumonia in older adults: a prospective, test-negative study. J Infect Dis. 2021 Sep 19;jiab474. Online ahead of print. DOI:https://doi.org/10.1093/infdis/jiab474.
- Diseases NIoI. 23-valent pneumococcal polysaccharide vaccine fact sheet. 2018. [cited 2021 December 24]. https://www.mhlw.go.jp/file/05-Shingikai-10601000-Daijinkanboukouseikagakuka-Kouseikagakuka/0000184910_1.pdf
- Matanock A, Lee G, Gierke R, et al. Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged ≥65 years: updated recommendations of the advisory committee on immunization practices. MMWR. 2019;68(46):1069–1075.
- National Institute for Public Health and the Environment Ministry of Health, Welfare and Sport, Netherland. Information for policy makers. [ cited 2021 December 24]. https://www.rivm.nl/en/pneumococci/information-for-policy-makers
- Haut Conseil de la Santé Publique. Infections à pneumocoque: recommandations vaccinales pour les adultes. Avis mis à jour le 27 Nov 2017. [cited 2021 December 24]. https://www.hcsp.fr/explore.cgi/avisrapportsdomaine?clefr=636