An analysis of the potential impact of pneumococcal conjugate vaccine (PCV) in India found that introducing PCV vaccine will protect the population from potentially catastrophic health expenditures due to treatment and hospitalizations for pneumococcal disease – saving an estimated $49-63 million in out-of-pocket expenditures each year, depending on the assumed vaccination coverage rate. Financial protection will be greatest for the poorest households, with the poorest quintile is estimated to have the greatest savings in out-of-pocket expenditures of all wealth quintiles.
Economics & Return on Investment
Continuing vaccination in Kenya will prevent thousands of deaths and be cost-effective
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.
During a meningitis outbreak in Burkina Faso, families spent $90 on treatment, causing financial strain and loss of income
During a meningococcal meningitis epidemic in Burkina Faso, households spent, on average, US$90 for treatment and other direct costs for family members with the disease. These costs, the equivalent of one third of the country’s annual GDP per capita, were in addition to the loss of income and assets from family members caring for patients.
Vaccinating against cholera is cost-effective, especially for high-risk populations and areas with high fatality rates
A comprehensive review of the economics of cholera and cholera prevention concluded that vaccination using oral cholera vaccines can be cost-effective, especially when herd effects are taken into account and when vaccination is administered to populations and age groups with high incidence rates (e.g., children) and to areas with high cholera case fatality rates.
Administering hepatitis B immune globulin to newborns in addition to vaccination prevents more infections and is cost-effective
In a study of different strategies for preventing hepatitis B infections in newborns in a Burmese refugee population with a high infection rate, administering hepatitis B immune globulin to newborns whose mothers test positive through a rapid diagnostic test — in addition to vaccinating all newborns with a birth dose — prevented twice as many infections in newborns than vaccination alone and was cost-effective (while the current strategy of providing immune globulin only after a confirmatory lab test was done was not). Thus, this strategy could be considered for similar marginalized or poor populations.
Vaccinating children in high-risk slum areas in Bangladesh can effectively control cholera and save lives
A study using local epidemiological and economic data found that vaccinating children 1-14 years old in high-risk slum areas in Dhaka, Bangladesh using a locally-produced oral cholera vaccine provided through periodic campaigns would be a highly cost-effective means of controlling endemic cholera — reducing cholera incidence in the entire population by 45% over 10 years and costing US$440-635 per DALY averted. Vaccinating all persons aged one and above would reduce incidence much further (by 91%) but would be less cost-effective.
Dengue illness is costly for low-income families, but immunization can help reduce the economic burden
In a standardized survey of the costs of dengue illness in three highly endemic countries, the economic burden of dengue was greatest on Vietnamese and Colombian low-income families, whose total costs, including lost wages, outpatient and inpatient cases combined, average 36-45% of their monthly household income. In Thailand, although significant, the economic burden was 17% less than the other countries, due to Thailand’s universal health insurance system.
China could save money by including the Hib vaccine in the national immunization program
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.
Vaccinating pregnant women in Brazil with Tdap vaccine would greatly reduce pertussis cases and deaths in infants
In Brazil, where pertussis cases have climbed, mainly in infants <4 months of age, vaccinating pregnant women with Tdap vaccine at the same coverage rate as influenza vaccination in pregnant women (57%) would reduce pertussis cases in children under 1 year of age by 41%, deaths by 43%, and would be cost-effective, according to the WHO thresholds.
Investments in influenza pandemic preparedness has huge economic benefits, potentially saving billions of dollars
Although the upfront investment in preparedness is costly – severe influenza pandemic preparedness is US$4.5bn a year – the estimated annual economic benefits would total US$60bn and US$490bn through averted deaths. “Even if only one tenth of these benefits were to materialize, the returns to public investment in preparedness would still be extraordinarily high.”