Purpose: Vaccination programmes are an expensive public health investment, particularly in low/middle income countries. However, traditional methods for assessing the value of vaccination (such as cost-utility analysis) ignore many of their broader benefits that may be of interest to policy makers in such countries. In order to assist policy makers, the World Health Organization commissioned a study to investigate the usefulness and feasibility of methods of capturing these broader benefits.
Method: The study consisted of (i) a systematic review of existing micro- and macroeconomic measurement tools to investigate the (beneficial and detrimental) effects of vaccination, (ii) an internet questionnaire and face-to-face interviews of key stakeholders to determine which of the effects were most useful to decision making, and (iii) a workshop with experts on decision analysis and health economics related to vaccination to discuss the feasibility of using these tools in practice.
Result: Benefits of vaccination that have been discussed in studies include improvements to non-health budgets (as a result of increased taxation and reduced spending on welfare), lifetime productivity gains (due to reduced cognitive impairment, preventing physical handicap and improved educational outcomes), improved age-dependency ratio (as a result of reducing child mortality and hence reducing fertility rates) and externalities to the wider community (such as the effect of a child’s vaccination on non-vaccinated community members). Many of these benefits are relevant to stakeholders in low/middle income countries and are feasible to implement in decision analytic studies.
Conclusion: Besides traditional cost-utility analyses, other tools that reflect the broader benefits of vaccination can contribute to improved decision making in low/middle income countries.
See more of: The 33rd Annual Meeting of the Society for Medical Decision Making