Economic evaluations of vaccination have traditionally focused on a relatively narrow set of vaccine benefits, such as the health gains yielded to individuals and directly averted medical care costs among those who are immunized. In recent years, however, researchers have identified additional vaccination benefits that should be incorporated into economic evaluations in order to reflect vaccination’s full value. These benefits, commonly referred to as broad benefits, include outcome-related productivity gains, care-related productivity gains, behavior-related productivity gains, health-based community externalities, reduction of comorbidities and nosocomial infections, risk reduction gains, and improvements in social equity (see Table 1)
Table 1: Bloom framework 2016
Early efforts to estimate the magnitude of these broader benefits suggest that vaccination has been substantially undervalued, which has important implications for public and private vaccine policy and human health and welfare. However, quality evidence of the real-world effects of vaccination remains lacking in many cases. More and better data are needed to advance the emerging line of research on the value of vaccination.
There are a number of concrete steps that the research community and other vaccination stakeholders must take to advance our current state of knowledge. We need to identify and collect new and better sources of data to quantify the magnitude of benefits theorized in various value of vaccination frameworks. Studies and results need to be tailored to their use contexts to be maximally relevant to decision-makers. Additionally, the diverse communities of vaccination research and implementation stakeholders must maintain open channels of communication to collaborate more effectively and create positive health impact.
Crucial topics for future research include estimation of the value of prospective vaccines for emerging and high-threat infectious diseases (HIV, MRSA, Ebola, Zika, etc.) and assessment of the value of vaccines to individuals and countries in the form of demographic dividends and economic growth. Economic modeling could also play a crucial role in assessing the full value of vaccination in areas where data are lacking. For example, models could be used to estimate the impacts of vaccination on health, social, and economic outcomes such as birthweight, educational attainment, cognitive development, labor force participation, individual earnings, the rate of antimicrobial resistance, herd effects, social and economic inequality, and macroeconomic performance.
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