Key Concept

Key Evidence: An analysis of current measles vaccination program in the eastern Chinese province of Zhejiang (which provides 1 dose of measles-rubella vaccine at 8 months of age and 1 dose of MMR at 18 months) estimated that, for every dollar spent on immunization, the health system saves $6.06 in treatment costing, including the costs of treating complications and long-term sequelae, such as hearing loss.

Zeng Y, Leo M, Chen J et al. 2019. An economic evaluation of the current measles vaccination program: a case study in Zhejiang Province, east China. Vaccine. 37(23).
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Key Evidence: A multi-site study of cholera vaccination programs found that the vaccine was cost-effective in school- and community-based vaccination programs for children in India, Mozambique, and Indonesia.

Jeuland, M., Cook, J., Poulos, C., et al 2009. Cost-effectiveness of new-generation oral cholera vaccines: A multisite analysis. Value Health. 23(2).
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Key Evidence:A study assessing the cost-effectiveness of Pneumococcal Conjugate Vaccine (PCV) demonstrated that nealy 38,000 cases of invasive pneumococcal disease were averted in the first five years post introduction of PCV in the US. These results, based on active surveillance data also revealed that the costs averted translated to US $112,000 per life year saved.

Ray, G.T., Whitney, C., Fireman, B., et al 2006. Cost-effectiveness of pneumococcal conjugate vaccine: evidence from the first 5 years of use in the United States incorporating herd effects. Pediatric Infectious Disease Journal. 25(6).
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Key Evidence: PCV7 use in Argentina resulted in an estimated cost of US$5,599 per life year gained. The purchase of the 4 doses of vaccine for the entire cohort at a cost of US$26.5 per dose would required an investment of US$73,823,806.00. This investment would significantly reduce the number of deaths brought about by cases of meningitis, bacteremia, pneumonia, otitis media and meningitis sequelae. The resultant decrease in morbidity and mortality coupled with herd immunity offered by immunization would contribute substantially to national productivity making PCV immunization a highly cost effective strategy.

Giglio, N.D., Cane, A.D., Micone, P., et al 2010. Cost-effectiveness of the CRM-based 7-valent pneumococcal conjugated vaccine (PCV7) in Argentina. Vaccine. 28(11).
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Key Evidence: Assuming 90% coverage, a 9-valent PCV (PCV9) program in The Gambia would prevent approximately 630 hospitalizations, 40 deaths, and 1000 DALYs, for the birth cohort over the first 5 years of life. The estimated cost would be $670 per DALY averted in The Gambia.

Kim, S., Lee, G. and Goldie, S. 2010. Economic evaluation of pneumococcal conjugate vaccination in The Gambia. BMC Infectious Diseases. 10(260).
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Key Evidence: A study in Australia estimated that adding dTpa vaccination for pregnant women to the current pertussis immunization program for children would prevent an additional 8,800 symptomatic pertussis cases (mostly unreported) and 146 hospitalizations each year in all ages, including infants and their mothers, as well as one death every 22 months. The study found maternal pertussis vaccination to be cost-effective.

From the VoICE Editors: Note: The formulation used in this study is abbreviated dTpa.

Saul N, Wang, Bag S et al. 2018. Effectiveness of maternal pertussis vaccination in preventing infection and disease in infants: the NSW Public Health Network case-control study. Vaccine. 36(14).
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Key Evidence: An economic analysis in Palestine found that including rotavirus in the routine immunization program is a cost-effective intervention in children under 5 years old. The study estimated that between 2016–2025, rotavirus vaccination in Palestine has the potential to avert approximately 101,000 severe episodes of rotavirus gastroenteritis cases. Avoiding these treatment costs could lead to estimated savings of approximately $14 million for the health system and approximately $22 million for the society (in 2018 US dollars).

Debellut, F., Jaber, S., Bouzya, Y., Sabbah, J., Barham, M., Abu-Awwad, F., ... & Mvundura, M. 2020. Introduction of rotavirus vaccination in Palestine: An evaluation of the costs impact and cost-effectiveness of ROTARIX and ROTAVAC. PLoS ONE.
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Key Evidence: An impact and cost-effectiveness study of rotavirus vaccination in Mongolia estimated that rotavirus vaccination, from the government perspective, would be highly cost-effective, with a cost per DALY averted of $412 for the low-cost ROTAVAC vaccine produced in India and around $1,000 for the two other available vaccines.

Lusvan M-E, Debellut F, Clark A et al. 2019. Projected impact, cost-effectiveness, and budget implications of rotavirus vaccination in Mongolia. Vaccine. 37(6).
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Key Evidence: This study provided an updated model of the cost-effectiveness of rotavirus vaccination in children younger than 5 years across 73 countries previously or currently eligible for Gavi support. The researchers found evidence that rotavirus vaccination is still a cost-effective investment in Gavi countries, projected to save approximately $484 million (around $48 million per year) from the government perspective and $878 million (around $90 million per year) from the societal perspective between 2018 and 2027, by preventing 158.6 million cases of rotavirus gastroenteritis, 80.7 million outpatient visits, 7.9 million hospitalizations, 14.7 million Disability-Adjusted Life Years, and nearly 600,000 deaths.

Debellut, F., Clark, A., Pecenka, C., Tate, J., Baral, R., Sanderson, C., ... & Atherly, D. 2019. Re-evaluating the potential impact and cost-effectiveness of rotavirus vaccination in 73 Gavi countries: a modelling study. The Lancet Global Health. 7(12).
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Key Evidence: An analysis in Kenya found that, although the government will need to more than double its current vaccine budget to continue using PCV after GAVI support ends, continuing the vaccination will prevent more than 101,000 cases of invasive pneumoccocal disease and pneumonia, more than 14,000 deaths over an 11-year period, and would be cost-effective (cost per DALY of $153 by 2032), even at the full GAVI price of US$3.05 per dose.

Ojal J, Griffiths U, Hammitt LI et al. 2019. Sustaining pneumococcal vaccination after transitioning from Gavi support: a modelling and cost-effectiveness study in Kenya. Lancet Global Health. 7(5).
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