VoICE Immunization Evidence: Cost effectiveness
An analysis of the impact of rotavirus vaccine in 25 Gavi countries found that the rates of vaccination in all countries were highest, and risk mortality lowest, in the top two wealth quintiles’ coverage. Countries differed in the relative inequities in these two underlying variables. Cost per DALYs averted is substantially greater in the higher quintiles. In all countries, the greatest potential vaccine benefit was in the poorest quintiles; however, reduced vaccination coverage lowered the projected vaccine benefit.
Rheingans, R., Atherly, D., and Anderson, J. 2012. Distributional impact of rotavirus vaccination in 25 GAVI countries: Estimating disparities in benefits and cost-effectiveness. Vaccine. 30S:A14-A23.
A study looking at the impact of pneumococcal vaccine introduction and scaling up pneumonia treatment in Ethiopia found that 30-40% of all deaths averted by these interventions would be expected to occur in the poorest wealth quintile. The greatest resulting financial risk protection would also be concentrated among the bottom income quintile.
Johannsen, K.A, Memirie, S.T., Pecenka, C. et al 2015. Health gains and financial protection from pneumococcal vaccination and pneumonia treatment in Ethiopia: Results from an extended cost-effectiveness analysis. PLOS ONE. 10(12).
A study of measles vaccine in Bangladesh found that children from the poorest quintile were more than twice as likely to die as those from the least quintile in the absence of measles vaccination. The difference in mortality between unvaccinated and vaccinated was statistically significant (p<0.10) and robust across alternative measures of socioeconomic status.
Bishai, D., Koenig, M., and Khan, M.A. 2003. Measles vaccination improves the equity of health outcomes: evidence from Bangladesh. Health Economics. 12(5):415-9.