‘Vaccines are incredibly good value,’ says Professor Mark Jit. ‘In fact, they are one of the best value public health medical interventions that exist.’
Prof Jit is the Chair of the Department of Global and Environmental Health at New York University. He models how diseases spread and calculates the cost-effectiveness of vaccination.
Policy-makers can turn to this hard evidence when deciding whether investing in immunisation programmes offers economic value. But the value of each vaccine depends on several factors – including the costs of the vaccine and delivering immunisation programmes; the vaccine’s effectiveness in preventing illness and death; and the incidence of the disease it prevents.
In addition, public health policies are sometimes shaped by other factors. For example, it can take time before new vaccines are funded. And while infant immunisation is already well established as ‘good value’ in the minds of policymakers, there are challenges in ensuring that life-course immunisation programmes are supported.
‘The vaccines we’ve had for decades – against measles, whooping cough, rubella – have saved hundreds of millions of lives,’ he explains. ‘They have probably saved one life every six minutes.’
‘Newer vaccines against Covid-19, RSV and HPV cancers, for example, save lives too but vaccines that have just been developed are more expensive,’ Prof Jit says. ‘So, countries with limited resources have to make difficult decisions about whether they can afford to introduce them. And that’s where economic evaluations come in.’
In this video interview, recorded as part of a series for the Coalition for Life-Course Immunisation, we discuss the criteria used to calculate the value of a vaccine. The health impact of vaccines can be profound.
Not only do vaccines prevent illness and save lives, they keep people out of hospitals, freeing up beds for others in the community who may need them. Newer vaccines against RSV, for example, have been shown to reduce hospitalisation in older people by 82%, while shingles vaccine is associated with lower risk of dementia.
Read more: Adult vaccination gives 19x return on investment
‘Looking at diseases that put a lot of people in hospital, such as rotavirus which causes diarrheal illness, there is a positive impact on health systems, lost work, and reduced anxiety for families,’ he says.
In some countries, the value is limited to the impact a vaccine has on the health system, while others take a wider view – incorporating the impact on workforce productivity, for example.
Impact of adult vaccination
It has taken time for decision-makers to appreciate the impact of immunisation for people at all stages of life. In part, this is because there is already an established system for rolling out a new childhood vaccine.
Read more: The public health paradox: vaccines are a victim of their own success
Introducing vaccines for adolescents, pregnant women or older people can be more complex in countries where this is not already a feature of preventative healthcare. However, past experience shows what can be achieved.
‘Covid showed us it is possible to deliver vaccines to people at all ages,’ Prof Jit says. ‘Lots of countries who had never delivered a vaccine to adults were able to do so.’
Read more: From heart health to dementia, vaccines are key to ageing well
Aside from mathematics, public health interventions face several challenges in attracting political attention and funding. Preventing future illness lacks the immediacy associated with improving someone’s health today.
‘With a vaccine, you will save someone’s life but you don’t know who it is – so it doesn’t have the same immediate tangible effect associated with saving the life of a person drowning in a river,’ Prof Jit notes. ‘Preventable interventions like vaccines tend to get overlooked, but mathematical modeling can provide evidence; we can tell policymakers whether they will improve lives by investing in immunisation.’
