Key Evidence: The 2008 Nigerian Demographic Health Survey data suggest that children in communities with high unemployment were 1/3 as likely to be fully immunized than children in communities with a medium level of unemployment.
Economic Growth and Productivity
The Economic Growth and Productivity sub-topic addresses the relationship between vaccine-preventable diseases or immunization and population-level productivity and economic growth. Productivity is a measure of output by a working individual or a population as a whole. It is the most important determinant of the standard of living of a group of people or of a nation.
5 Key Concepts
Key Evidence: In a retrospective cohort study among healthcare workers (HCWs) of an Italian academic healthcare trust during the 2017–2018 influenza season, non-vaccinated HCWs lost 2.47/100 person-days of work compared to 1.92/100 person-days of work among vaccinated HCWs (p < 0.001). This adds further evidence that absenteeism among HCWs is negatively correlated with influenza vaccination.
A school-located influenza vaccination program implemented in 95 preschools and elementary schools in California was associated with increased influenza vaccination coverage, decreased school absences due to illness, and lower influenza transmission across the community. The 11% increase in flu vaccination in children enrolled in target schools was associated with fewer flu hospitalizations in the community, including 160 fewer influenza hospitalizations per 100,000 among people aged 65 and older.
Key Evidence: Children hospitalized with rotavirus in Norway were absent from daycare for 6.3 days, on average, and 73% of their parents missed work — for a mean of almost 6 days. These data, which can be used in economic evaluations of rotavirus vaccination, show that work absenteeism resulting from having a child hospitalized with rotavirus poses a considerable economic burden on society.
Healthcare workers who received an influenza vaccine missed fewer days of work compared to non-vaccinated peers (1.74 vs 2.71 days/person). The study took place at a large Italian hospital that employed approximately 5,300 healthcare workers. The researchers examined a severe influenza season (2017/2018) as well as three moderate flu seasons (2010-2013).
Key Evidence: In the mid-1980s, the Indian government examined the effect of their universal immunization program on child mortality and educational attainment. Results indicate that exposure to the program reduced infant mortality by 0.4 percentage points and under five child mortality by 0.5 percentage points. These effects on mortality account for approximately one-fifth of the decline in infant and under five child mortality rates between 1985-1990. The effects are more pronounced in rural areas, for poor people, and for members of historically disadvantaged groups.
Key Evidence: In a study of immunization in the Philippines, children vaccinated against 6 diseases performed significantly better on verbal reasoning, math, and language tests than those who were unvaccinated. (note: Researchers did not find an association with physical growth.)
Key Evidence: A study of the economic burden of cholera in Africa found that 110,837 cases of cholera reported in 2007 resulted in an economic loss of $43.3 million, $60 million and $72.7 million US dollars, assuming life expectancies of 40, 53 and 73 years respectively.
Key Evidence: Researchers modeled the costs, using the UK’s 2004 economy, of potential pandemic flu in the UK. Costs of illness alone ranged between 0.5% and 1.0% of gross domestic product (£8.4bn to £16.8bn) for low fatality scenarios, 3.3% and 4.3% (£55.5bn to £72.3bn) for high fatality scenarios, and larger still for an extreme pandemic. Vaccination with a pre-pandemic vaccine could save 0.13% to 2.3% of gross domestic product (£2.2bn to £38.6bn); a single dose of a matched vaccine could save 0.3% to 4.3% (£5.0bn to £72.3bn), and two doses of a matched vaccine could limit the overall economic impact to about 1% of gross domestic product for all disease scenarios.
Key Evidence: An analysis of the impact of India’s Universal Immunization Program (UIP) on schooling attainment in adults found that women born after the UIP rollout attained 0.29 more schooling grades compared women from the same household born before UIP rollout. Among unmarried women, the UIP was associated with an increment of 1.2 schooling years, which corresponds to as much as an INR 35 (US $0.60) increase in daily wages.
Key Evidence: For every 6 children vaccinated against measles in a poor, largely rural community in South Africa, one additional grade of schooling was achieved.
Key Evidence: In 1996, a follow-up study was conducted on a 1974 randomized trial of tetanus and cholera vaccine administered to mothers. At the time of follow up in 1996, there was a clear pattern of increased educational attainment among children whose mothers received tetanus vaccine during pregnancy. This pattern was significant for the group of children born to vaccinated mothers with very low levels of education.