Use of vaccines, including strengthening existing immunization programs, provides opportunities for significant reductions in disease burden with resultant economic benefits. – VoICE
Key Concept

Key Evidence: A study of insurance claims in the U.S. for children under five estimated that, from 2007 to 2011, rotavirus vaccination prevented more than 176,000 hospitalizations, 242,000 emergency room visits and more than 1.1 million outpatient visits due to diarrhea — saving an estimated $924 million in direct health care costs over four years.

Pindyck T, Tate JE, Parashar UD 2018. A decade of experience with rotavirus vaccination in the United States – vaccine uptake, effectiveness, and impact. Expert Review of Vaccines. 17(7).
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Key Evidence: Vaccinating children against rotavirus in Bangladesh would prevent more than 50,000 outpatient visits and 40,000 hospitalizations in children under five each year, and reduce treatment costs by US$5.8 million over 2 years — nearly all (96%) from fewer hospitalizations. Since this study didn’t take herd effects into account, the actual impact would likely be greater.

Sarker AR, Sultana M, Mahumud RA, et al. 2018. Cost-effectiveness analysis of introducing universal childhood rotavirus vaccination in Bangladesh. Human Vaccines & Immunotherapeutics. 14(1).
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Key Evidence: If China — one of the few remaining countries in the world that haven’t introduced Hib vaccine in their national immunization program — decides to include the vaccine in their program, it could actually be cost saving; the vaccination costs would be less than the averted costs of illness from Hib meningitis and pneumonia, if a vaccine price matching UNICEF’s (US$2/dose) can be obtained. The vaccination will be cost-effective, but not cost saving, if the program pays the current market price in China of US$10 per dose.

Ning G, Yin Z, Li Y et al 2018. Cost-effectiveness of Haemophilus influenzae type b vaccines for infants in mainland China. Human Vaccines & Immunotherpeutics. 14.
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Key Evidence: In a study using actual data on hospitalizations and costs before and after PCV-10 vaccine was introduced in Brazil, an estimated 463,000 hospitalizations from all causes of pneumonia were prevented in persons less than 65 years of age over 5 years following introduction of the vaccine — saving an estimated US$147 million in hospitalization costs. Half of the costs averted were due to fewer hospitalizations in children under five, who were targeted for the vaccine, while the remaining half were due to fewer hospitalizations in persons 5-49 years of age, as a result of herd protection.

Andrade AL, Afonso ET, Minamisava R et al. 2017. Direct and indirect impact of 10-valent pneumococcal conjugate vaccine introduction on pneumonia hospitalizations and economic burden in all age groups in Brazil: A time-series analysis. PLoS One. 12(9).
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Key Evidence: Vaccination of infants with pneumococcal conjugate vaccines in 180, from the health system perspective, would save an estimated $3.2 billion per year worldwide in treatment costs and an additional $2.6 billion in societal costs (from reduced missed work and out-of-pocket expenditures)- for a total of $5.8 billion. These savings would partially offset the estimated global cost of vaccination of $15.5 billion per year.

From the VoICE Editors: The cost estimates were calculated in international dollars. 

Chen C, Liceras FC, Flasche S et al. 2019. Effect and cost-effectiveness of pneumococcal conjugate vaccination: a global modelling analysis. Lancet Global Health. 7(1).
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Key Evidence: A surveillance study over a 10-year period in the Gambia found that routine introduction of PCV led to a 33% reduction in the incidence of radiological pneumonia and a 27% decline in pneumonia hospitalizations in children. Reducing the rate of pneumococcal disease will not only save lives but will also reduce the substantial economic burden placed on families and health systems.

Mackenzie, G. A., Hill, P. C., Jeffries, D. J., Ndiaye, M., Sahito, S. M., Hossain, I., ... & Mackenzie, R. 2021. Impact of the introduction of pneumococcal conjugate vaccination on invasive pneumococcal disease and pneumonia in The Gambia: 10 years of population-based surveillance. The Lancet Infectious Diseases.
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Key Evidence: In 41 Gavi-eligible countries, it is estimated that without any rotavirus vaccine (RVV) coverage, an estimated 2.2 million Catastrophic Health Costs (CHC) cases and 600,000 Medical Impoverishment (MI) cases would occur due to rotavirus gastroenteritis. Unfortunately these figures would not significantly decrease under the current immunization forecasts because very few countries have introduced the RVV. However, with the introduction of RVV the number of CHC cases would drop to 1.3 million and MI cases to 400,000, representing a 40% reduction.

Riumallo-Herl, C., Chang, A.Y., Clark, S., et al. 2018. Poverty reduction and equity benefits of introducing or scaling up measles, rotavirus, and pneumococcal vaccines in low-income and middle-income countries: a modeling study. British Journal of Medicine Global Health. 3:e000612.
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Key Evidence: Researchers estimate that vaccinating against 10 diseases in the world’s 94 poorest countries between 2011-2020 will avert US$586 billion in costs of illness (including treatment costs, transportation costs, lost caretaker wages and productivity losses due to death and disability). The 73 Gavi-supported countries account for US$544 billion of the treatment costs averted.

Ozawa, S., Portnoy, A., Grewal, S., et al 2016. Return on investment from childhood immunization in low- and middle-income countries, 2011-2020. Health Affairs. 35(2).
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