Vaccines in poor countries have saved 20 million lives and 350 billion dollars since 2001

And that’s just direct costs. The estimated overall economic impact of vaccines is $820 billion.

From 2001 to 2020, vaccinations in the world’s poorest countries will have prevented 20 million deaths and saved $350 billion in healthcare costs, researchers project. The broader economic value from lives saved by vaccinations is estimated to be $820 billion. Researchers studied the impact of the Global Vaccine Alliance (Gavi) which was launched in 2000 to provide vaccines to children in the world’s poorest countries. Gavi has helped bring immunization to 580 million children, primarily in the 73 countries covered in the study’s analysis.

We spoke to Sachiko Ozawa, Ph.D., an associate professor at the UNC Eshelman School of Pharmacy, about the study, which was published in the Bulletin of the World Health Organization.

ResearchGate: What motivated you to study the value of vaccinations?

Sachiko Ozawa: Childhood immunization is one of the best development investments for humanity. But it is hard to appreciate the benefits of preventative measures like vaccination because it means that people did not become sick and are not visible to the community. Estimating the value of vaccinations is important in illustrating the health benefits and significant economic impact vaccinations are having around the world and encourage donors to continue investing in such a cost-effective measure.

RG: What did you find?

Ozawa: Vaccination efforts made in the world’s poorest countries since 2001 will have prevented 20 million deaths and saved $350 billion in costs related to illness by 2020. Immunization also brings benefits to society from the intrinsic value that people place on living longer and healthier lives. This intrinsic value of vaccination is estimated at $820 billion from vaccination against 10 diseases delivered in 73 low- and middle-income countries over 20 years.

RG: How do vaccines save money and lives?

Ozawa: Vaccination prevents illnesses, hospitalizations, disabilities, and deaths. Specifically, we estimated that 10 vaccines supported by Gavi, the Vaccine Alliance, in low- and middle-income countries will have prevented an estimated 500 million cases of illness, 70 million hospitalizations, 9 million cases of long-term disability and 20 million deaths by 2020. This translates to cost savings from averted treatment, health care related transportation costs, productivity losses to caregivers and productivity losses due to disability and death, estimated at $350 billion from immunizations in poor countries over two decades. We estimate the broader economic and social value of saving these lives and preventing disabilities at $820 billion.

RG: Can you take us though how you arrived at your figures?

Ozawa: Estimating the impact of vaccination at a large scale – across many countries, vaccines, and years – takes collaboration. This work was carried out in collaboration with disease modeling experts convened by Gavi and the Bill and Melinda Gates Foundation to estimate the global impact of immunization. Estimates of illnesses and deaths averted by vaccination come from disease-specific models based on the latest forecasts of vaccine demand and estimates of disease burden.

We used two methods to estimate the economic value. The first, called the cost of illness method, tallied the costs that could be saved by preventing illness. This included inpatient and outpatient treatment costs, costs to travel to health facilities, lost wages of caregivers to care for ill children, and the economic contributions the disabled and deceased children could have made to society had they been healthy. We also used a second method, called the full income approach, which captures the intrinsic value that people place on living longer and healthier lives, drawing on studies that probe the value that people place on this.

RG: Which vaccinations did you look at? Are there any infection specific vaccines that are comparatively more valuable than others?

Ozawa: We examined the impact of vaccination against 10 vaccine-preventable diseases: hepatitis B, human papillomavirus, Japanese encephalitis, measles, rotavirus, rubella, yellow fever and three strains of bacteria that cause pneumonia and meningitis (haemophilus influenzae type b, streptococcus pneumoniae, and Neisseria meningitidis serogroup A). We found that vaccination against hepatitis B, measles, and haemophilus influenzae type b and streptococcus pneumoniae provided the greatest economic benefits due to the large disease burden prevented.

RG: How close are we to achieving total vaccination coverage in low- and middle-income countries?

Ozawa: While significant progress has been made in improving access to life-saving vaccines, 19.5 million children still do not have access to a full course of the most basic vaccines according to the latest estimates of national immunization coverage from UNICEF and the World Health Organization. The children who miss out on these vaccines in low- and middle-income countries are often those in the poorest households, in remote locations and whose mothers have a low level of education.

Greater efforts by governments, development partners, and civil society are needed to support immunization and enable people to stay healthy and contribute to social and economic development. For example, the health and economic gains cannot be achieved without countries meeting the projected funding requirements for immunization programs, including the costs of vaccines, supply chain and service delivery. We estimate a funding gap of $6.9 billion over 2016-2020 to deliver vaccination programs across the same 73 countries.

RG: Do you think the return on vaccinations is similar in high-income countries? 

Ozawa: Because vaccines were introduced in high-income countries decades ago, it is much harder to understand what the disease burden would have been without vaccinations. Many things besides vaccination have also changed over the years. But if we take the disease burden experienced before vaccine introduction in high-income countries and apply them today, we would see that vaccinations are making a significant health and economic impact in preventing illnesses, disabilities and deaths.

When vaccination rates drop in high-income countries we see disease outbreaks. This proves that we are preventing illnesses, deaths, and health care costs from vaccinations in high-income countries. While vaccination rates for child immunizations are high, many adults remain unvaccinated. For example, we estimated the annual economic burden of adult vaccine-preventable diseases in the US at $9 billion. Regardless of country, vaccination is important for people to reach their full potential as active and productive members of society.

RG: How is the different from your earlier findings?

Ozawa: These results support our earlier findings on the return on investment of childhood immunizations across low- and middle-income countries, where we found a $16 to $44 return for every dollar invested in immunization over the decade based on the same two methods used to estimate the economic value.  Immunizations are an excellent investment. But to make the estimated return a reality, people must continue to demand vaccines, and country governments and donors must honor commitments to mobilize resources to support and strengthen immunization programs.

Featured image courtesy of UNICEF Ethiopia.