VoICE Immunization Evidence: Cost effectiveness
The indirect benefit of immunization to unvaccinated individuals (herd immunity) increases the cost-effectiveness of vaccines.
Key Evidence: The evidence on cholera disease dynamics suggests that significant herd protection can result from a relatively small number of immunizations, particularly in endemic areas where there is some natural immunity among the population.
Jeuland, M., Lucas, M., Clemens, J.,et al 2009. A Cost–Benefit Analysis of Cholera Vaccination Programs in Beira, Mozambique. World Bank Economic Review. 23:235–267.
Key Evidence: In Japan, which has experienced a re-emergence of pertussis among adolescents and adults, vaccinating pregnant women with the Tdap vaccine would be cost effective in preventing the illness in young infants (<3 months of age) and in mothers, according to the WHO definition of cost effectiveness. This is true even if only 50% of pregnant women receive the vaccine.
Hoshi S-L, Seposo X, Okubo K, Kondo M 2018. Cost-effectiveness of analysis of pertussis vaccination during pregnancy in Japan. Vaccine. 36.
Key Evidence: Pertussis causes nearly 200,000 deaths in children worldwide, nearly all in infants too young to be vaccinated. Vaccinating pregnant women against pertussis with a single dose of Tdap vaccine would be 89% effective in protecting infants against the disease over their first 2 months of life and would reduce pertussis incidence in newborns in the U.S. by 68% (assuming 75% of mothers are vaccinated). This strategy is cost-effective, whereas vaccinating the father before the birth or vaccinating parents and/or other family members after the child is born would not be.
From the VoICE Editors: The analysis assumes a vaccination cost of ≈$44 per dose.
Atkins KE, Fitzpatrick MC, Galvani AP, Townsend JP 2016. Cost-effectiveness of pertussis vaccination during pregnancy in the US. American Journal of Epidemiology. 183(12).
Key Evidence: The cost-effectiveness of vaccinating infants with PCV-13 in China was estimated to be 21 times greater when the indirect effects of vaccination in reducing invasive pneumococcal disease and hospitalized cases of pneumonia in older (unvaccinated) individuals was taken into account — with costs per quality of life-year gained (QALY) of around US$564 (Y3,777) vs. $11,836 (Y79,204) when only the direct impact on vaccinated children is considered.
Shen K, Wasserman M, Liu D et al. 2018. Estimating the cost-effectiveness of an infant 13-valent pneumococcal conjugate vaccine national immunization program in China. PLoS One. 13(7).