The Knowledge Hub

Immunization programs have saved millions of lives, especially among children, and will continue to do so in the future

Increases in vaccine coverage and the introduction of new vaccines into LMICs have had a major impact in reducing mortality. Vaccination programs for ten selected pathogens will have averted an estimated 69 million deaths in 98 low- and middle-income countries between 2000 and 2030. Most of this impact has been concentrated in a reduction in mortality among children younger than 5 years (57% reduction), most notably from measles. These public health gains are predicted to increase in coming decades if progress in increasing vaccine coverage is sustained.

Li X, Mukandavire C, Cucunubá ZM et al.. 2021. Estimating the health impact of vaccination against ten pathogens in 98 low-income and middle-income countries from 2000 to 2030: a modelling study. The Lancet. 397(10272).

Globally, immunization has a high return on investment saving billions of dollars by preventing disability, health costs, and premature deaths

By preventing illness, disability, premature death, lost wages, and other costs, this modeling study found that vaccines against ten pathogens averted $828.5 billion of economic burden in 94 low- and middle-income countries between 2021 and 2030. Immunization programs provided a high return on investment (ROI), with projections for net benefits of vaccine programs estimated at $1,445.3 billion (using a cost-of-illness approach) and $3,371.5 billion (using a value-of-a-statistical-life approach) from 2011 to 2030. For every $1 invested in immunization, there was a return on investment of $20 using cost-of-illness and $52 using a value-of-a-statistical-life approach.

Sim SY, Watts E, Constenla D et al.. 2020. Return On Investment From Immunization Against 10 Pathogens In 94 Low- And Middle-Income Countries, 2011–30. Health Affairs. 39(8).

Immunization with pneumococcal and rotavirus vaccines can prevent millions of episodes of treatment with antibiotics

In this analysis of data from large-scale studies of households, two vaccines recently implemented in the WHO EPI, pneumococcal conjugate vaccines and live attenuated rotavirus vaccines, were estimated to confer 20% and 11% protection against antibiotic-treated episodes of acute respiratory infection and diarrhea, respectively, in the age groups with the greatest disease burden attributable to these pathogens. Under current coverage levels, pneumococcal and rotavirus vaccines are estimated to prevent 24 million and 14 million episodes, respectively, of antibiotic-treated illness each year among children in LMICs less than five years old. An additional 40 million episodes could be prevented through achievement of universal coverage targets.

Lewnard JA, Lo NC, Arinaminpathy N et al.. 2020. Childhood vaccines and antibiotic use in low- and middle-income countries. Nature. 581.

Immunizing children against rotavirus in Palestine can save money and prevent severe cases of gastroenteritis

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 et al.. 2020. Introduction of rotavirus vaccination in Palestine: An evaluation of the costs impact and cost-effectiveness of ROTARIX and ROTAVAC. PLoS ONE. 15(2).

Rotavirus vaccination saves money and prevents millions of cases, hospitalizations, and deaths

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 et al.. 2019. Re-evaluating the potential impact and cost-effectiveness of rotavirus vaccination in 73 Gavi countries: a modelling study. Lancet Global Health. 7(12).

Rotavirus vaccination reduces the risk of childhood seizures by 20-34% in the US and Spain

Seizures are the most common non-gastrointestinal symptom associated with rotavirus infection. Studies have found that rotavirus vaccination significantly reduced the risk of childhood seizures during the year following vaccination by approximately 20% for seizures requiring emergency care or hospitalization in the US and by 16-34% for childhood seizures requiring hospitalization in Spain.

Rivero-Calle I, Gomez-Rial J, Martinon-Torres F. 2016. Systemic features of rotavirus infection. Journal of Infection. 72.

Immunization against rotavirus is cost-effective, especially in poorer regions, saving lives and reducing disabilities

According to a cost-effectiveness study of rotavirus vaccination in Pakistan, the vaccine would be the most cost-effective in the poorer provinces of Sindh and Balochistan (that also have the highest rates of death from rotavirus)- with a cost per disability-adjust life year averted $155-$167 compared to almost $600 in the wealthier region of Islamabad. Within all regions, vaccination was the most cost-effective among the two poorest income groups (quintiles), and was almost 12 times more cost-effective in the poorest households in the most marginalized region than in the wealthiest households in the most advantaged region (cost/DALY averted of $76 vs. $897).

Rheingans R, Anderson JD, Bagamian KH et al.. 2018. Effects of geographic and economic heterogeneity on the burden of rotavirus diarrhea and the impact and cost-effectiveness of vaccination in Pakistan. Vaccine. 36(51).

Expanding rotavirus vaccination coverage in Pakistan would greatly reduce deaths, especially among the poorest children

A cost-effectiveness analysis of rotavirus vaccination in Pakistan found that, if rotavirus vaccination coverage was equally high across regions and income groups, the percent reduction in deaths due to rotavirus would be 4 times greater in the highest risk regions than in the lowest-risk regions, and would be 3-4 times greater among children in the poorest versus the wealthiest households.

Expanding vaccination coverage among the poorest and most vulnerable children would substantially increase the overall impact of rotavirus immunization in Pakistan.

Rheingans R, Anderson JD, Bagamian KH et al.. 2018. Effects of geographic and economic heterogeneity on the burden of rotavirus diarrhea and the impact and cost-effectiveness of vaccination in Pakistan. Vaccine. 36(51).

Rotavirus vaccination in Mongolia is cost-effective, with low-cost vaccine saving lives and money

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 ME, Debellut F, Clark A et al.. 2019. Projected impact, cost-effectiveness, and budget implications of rotavirus vaccination in Mongolia. Vaccine. 37(6).

Rotavirus vaccination reduces the risk of childhood seizures requiring emergency care or hospitalization

Seizures are the most common non-gastrointestinal symptom associated with rotavirus infection. Studies have found that during the year following rotavirus vaccination the risk of childhood seizures were reduced by 18-21% for seizures requiring emergency care or hospitalization in the U.S. and by 16-34% for childhood seizures requiring hospitalization in Spain.

Rivero-Calle I, Gomez-Rial J, Martinon-Torres F. 2016. Systemic features of rotavirus infection. Journal of Infection. 72.