The Expanded Program on Immunization (EPI), launched by WHO in 1974, plays a vital role in public health, with China’s EPI covering over one-sixth of the global population through eight routine vaccines. This study estimated the health and economic impact of China’s EPI from 1974 to 2024. Using mathematical models comparing actual vaccination rates with a no-vaccination scenario, this study estimated that EPI averted 703 million cases, 2.48 million deaths, and 160 million disability-adjusted life years. Over the lifetime of birth cohorts, 707 million cases, 7 million deaths, and 279 million disability-adjusted life years were averted. From the societal perspective, the vaccination cost was estimated to be US$124 billion, while benefits reached US$2.4 trillion, yielding a benefit–cost ratio of 19.5. The study concludes that China’s EPI achieved significant health and economic gains, underscoring the need for continued investment to sustain and expand vaccination programs.
China’s Expanded Program on Immunization has significantly reduced disease burden and generated high economic returns over the past 50 years (1974-2024), emphasizing the need for continued investment in vaccination programs in China and globally.
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