TY - JOUR
T1 - Rethinking the benefits and costs of childhood vaccination
T2 - The example of the Haemophilus influenzae type b vaccine
AU - Bärnighausen, Till
AU - Bloom, David E.
AU - Canning, David
AU - Friedman, Abigail
AU - Levine, Orin S.
AU - O'Brien, Jennifer
AU - Privor-Dumm, Lois
AU - Walker, Damian
N1 - Funding Information:
We thank an anonymous reviewer for helpful comments. We also thank Christian Bjørnskov for useful suggestions and Larry Rosenberg and Marija Ozolins for research assistance. We gratefully acknowledge funding support from GAVI's PneumoADIP at The Johns Hopkins Bloomberg School of Public Health through the grant “Benefit–cost analyses for vaccination against pneumococcous, rotavirus, Haemophilus influenzae type b, and other vaccine-preventable diseases”. TB was supported by Grant 1R01-HD058482-01 from the National Institute of Child Health and Human, National Institutes of Health (NICHD/NIH) and by the Wellcome Trust, United Kingdom .
PY - 2011/3/16
Y1 - 2011/3/16
N2 - Economic evaluations of health interventions, such as vaccinations, are important tools for informing health policy. Approaching the analysis from the appropriate perspective is critical to ensuring the validity of evaluation results for particular policy decisions. Using the example of cost-benefit analysis (CBA) of Haemophilus influenzae type b (Hib) vaccination, we demonstrate that past economic evaluations have mostly adopted narrow evaluation perspectives, focusing primarily on health gains, health-care cost savings, and reductions in the time costs of caring, while usually ignoring other important benefits including outcome-related productivity gains (improved economic productivity due to prevention of mental and physical disabilities), behavior-related productivity gains (economic growth due to fertility reductions as vaccination improves child survival), and community externalities (herd immunity and prevention of antibiotic resistance). We further show that potential cost reductions that could be attained through changes in the delivery of the Hib vaccine have also generally been ignored in economic evaluations. Future economic evaluations of childhood vaccinations should take full account of benefits and costs, so that policymakers have sufficient information to make well-informed decisions on vaccination implementation.
AB - Economic evaluations of health interventions, such as vaccinations, are important tools for informing health policy. Approaching the analysis from the appropriate perspective is critical to ensuring the validity of evaluation results for particular policy decisions. Using the example of cost-benefit analysis (CBA) of Haemophilus influenzae type b (Hib) vaccination, we demonstrate that past economic evaluations have mostly adopted narrow evaluation perspectives, focusing primarily on health gains, health-care cost savings, and reductions in the time costs of caring, while usually ignoring other important benefits including outcome-related productivity gains (improved economic productivity due to prevention of mental and physical disabilities), behavior-related productivity gains (economic growth due to fertility reductions as vaccination improves child survival), and community externalities (herd immunity and prevention of antibiotic resistance). We further show that potential cost reductions that could be attained through changes in the delivery of the Hib vaccine have also generally been ignored in economic evaluations. Future economic evaluations of childhood vaccinations should take full account of benefits and costs, so that policymakers have sufficient information to make well-informed decisions on vaccination implementation.
KW - Childhood vaccination
KW - Economic evaluation
KW - Haemophilus influenzae type b vaccine
KW - Review
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U2 - 10.1016/j.vaccine.2010.11.090
DO - 10.1016/j.vaccine.2010.11.090
M3 - Review article
C2 - 21159324
AN - SCOPUS:79952364267
SN - 0264-410X
VL - 29
SP - 2371
EP - 2380
JO - Vaccine
JF - Vaccine
IS - 13
ER -