New VoVRN publications: Costs and benefits of COVID-19 vaccine mandates, new evidence on childhood vaccination in India

1. The Benefits and Costs of U.S. Employer COVID-19 Vaccine Mandates

In 2021, the Biden Administration issued mandates requiring COVID-19 vaccinations for U.S. federal employees and for some healthcare and private sector workers. Many of these mandates faced legal challenges and some were halted or delayed. However, thorough assessments of their benefits and costs were not used in either the decision to implement them or the efforts to terminate them. VoVRN researchers have attempted to address this by estimating the direct costs and health-related benefits if these vaccination requirements had been implemented as designed. Compared with the vaccination rates observed in January 2022, they found that the mandates could have led to 15 million additional vaccinated individuals, increasing the overall proportion of the fully vaccinated U.S. population to 68%. In scenarios involving the emergence of a more transmissible variant, the estimated net benefits were over $16,000 per additional vaccinated individual, with more than 20,000 total deaths averted. In scenarios involving a fading pandemic, existing vaccination-acquired or infection-acquired immunity provides sufficient protection, and the mandates’ benefits are unlikely to exceed their costs. Thus, mandates may be most useful when the consequences of inaction are catastrophic.

2. Economic vs. Epidemiological Approaches to Measuring the Human Capital Impacts of Infectious Disease Elimination

Economic literature has examined in depth the impact of disease-eliminating health interventions, such as the rollout of new vaccines, on human capital. However, most of these studies have focused on only part of the disease burden – such as mortality – rather than actual infection counts, which can be hard to measure. VoVRN researchers developed a dynamic epidemiological model to estimate more precise measles infection rates in U.S. cohorts during the measles vaccine introduction. They used these to examine educational, economic, and health outcomes, the results of which they compared to those derived using existing economic approaches. They found that using disease burden rather than infection rates seems more relevant for assessing human capital impacts, which supports the existing economic approaches.

3. Childhood vaccinations and demographic transition: Long-term evidence from India

Childhood vaccines can increase population growth in the short term by improving the survival rates of young children. Over the long run, reductions in child mortality rates are associated with lower demand for children and fertility rates (the “demographic transition”). Vaccines can potentially aid demographic transition by lowering child mortality and improving future health, schooling, and labor market outcomes of vaccinated mothers, but these long-term demographic benefits remain untested. VoVRN researchers examined the demographic effects of India’s national childhood vaccination. They found that women exposed to the national vaccination program are 2% less likely to have at least one child and want 2% fewer children in their lifetime as compared those born before the program.

4. A shot at economic prosperity: Long-term effects of India’s childhood immunization program on earnings and consumption expenditure

Routine childhood vaccinations are among the most cost-effective interventions. In recent years, the broader benefits of vaccines, which include improved cognitive and schooling outcomes, have also been established. VoVRN researchers evaluated the long-term economic benefits of India’s national program of childhood vaccinations, known as the Universal Immunization Programme. They find that exposure to the national vaccination program in infancy increases weekly wages by 13.8% and monthly per capita household consumption expenditure by 2.9%.

5. Valuing COVID-19 Morbidity Risk Reductions

Many economic analyses, including those that address the COVID-19 pandemic, focus on the value of averting deaths and do not include the value of averting nonfatal illnesses. Yet, incorporating the value of averting nonfatal cases may change conclusions about the desirability of the policy. Researchers from the Center for Health Decision Science, Harvard T.H. Chan School of Public Health describe and implement an approach for approximating the value of averting nonfatal illnesses or injuries and apply it to COVID-19 in the USA. Gains from averting COVID-19 morbidity were estimated at about 0.01 quality-adjusted life year (QALY) per mild case averted, 0.02 QALY per severe case, and 3.15 QALYs per critical case. These gains translate into monetary values of about $5300 per mild case, $11,000 per severe case, and $1.8 million per critical case.