Cost of illness (COI) estimates can be measured empirically or generated with models. Models allow us to project the economic benefits of vaccines and estimate vaccine impact in regions lacking empirical data by integrating costs and epidemiological data from different sources.

The DOVE Cost of Illness (DOVE-COI) models estimate the costs averted by vaccination against ten antigens: hepatitis B, Haemophilus influenzae type B, human papillomavirus, Japanese encephalitis, rubella, yellow fever, pneumococcal pneumonia, measles, meningitis and rotavirus. Focusing on 94 low- and middle-income countries (LMICs) from 2001 to 2030, the models estimate three short-term costs averted by vaccines (treatment costs, lost caretaker wages, and transportation costs) and two long-term costs averted (productivity loss due to disability and death). Results are used at the global and regional level to advocate for new vaccine introduction and increased vaccine coverage.

Beyond costs averted, supplemental models use value per statistical life-year methods to estimate the social value of lives saved through preventing disability and death.

DOVE-COI model outputs are frequently used by stakeholders such as Gavi, the Vaccine Alliance and the Bill & Melinda Gates Foundation for advocacy campaigns and to inform investment decisions. The results are also used for the DOVE Return on Investment analysis.

The DOVE-COI models link the health and economic benefits resulting from vaccines. The graph below shows the economic and social value of averted costs of illness and deaths annually, for 10 diseases in 73 Gavi-supported low- and middle-income countries, 2001–2020 (Ozawa, 2017).


Ozawa S, Clark S, Portnoy A, Grewal S, Stack M, Sinha A, Mirelman A, Franklin H, Friberg I, Tam Y, Walker N, Clark A, Ferrari M, Suraratdecha C, Sweet S, Goldie S, Garske T, Li M, Hansen P, Johnson H, Walker D. Estimated economic impact of vaccinations in 73 low- and middle-income countries, 2001-2030. Bulletin of the World Health Organization 2017; 95: 629-638.

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