Systematic review of studies evaluating the broader economic impact of vaccination in low and middle income countries

BMC Public Health

Mark Jit¹  Silvia Evers³  Inge van der Putten³  Raymond Hutubessy²  Rohan Deogaonkar⁴ 

[1] Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK;Initiative for Vaccine Research, World Health Organization, Geneva, Switzerland;Department of Health Services Research, Maastricht University, Maastricht, The Netherlands;Health Economics Unit, University of Birmingham, Birmingham, UK

关键词: Developing countries;    Low and middle income countries;    Immunization;    Vaccines;    Externalities;    Cost-effectiveness analysis;    Economic evaluations;   

Others  :  1162965
DOI  :  10.1186/1471-2458-12-878

 received in 2012-06-19, accepted in 2012-10-09,  发布年份 2012

【 摘 要 】

Background

Most health economic evaluations of childhood vaccination only capture the health and short-term economic benefits. Measuring broader, long-term effects of vaccination on productivity and externalities could provide a more complete picture of the value of vaccines.

Method

MEDLINE, EconLit and NHS-EED databases were searched for articles published between January 1990 and July 2011, which captured broader economic benefits of vaccines in low and middle income countries. Studies were included if they captured at least one of the following categories on broader economic impact: outcome-related productivity gains, behaviour-related productivity gains, ecological externalities, equity gains, financial sustainability gains or macroeconomic benefits.

Results

Twenty-six relevant studies were found, including observational studies, economic models and contingent valuation studies. Of the identified broader impacts, outcome-related productivity gains and ecological externalities were most commonly accounted for. No studies captured behaviour-related productivity gains or macroeconomic effects. There was some evidence to show that vaccinated children 8–14 years of age benefit from increased cognitive ability. Productivity loss due to morbidity and mortality was generally measured using the human capital approach. When included, herd immunity effects were functions of coverage rates or based on reduction in disease outcomes. External effects of vaccines were observed in terms of equitable health outcomes and contribution towards synergistic and financially sustainable healthcare programs.

Conclusion

Despite substantial variation in the methods of measurement and outcomes used, the inclusion of broader economic impact was found to improve the attractiveness of vaccination. Further research is needed on how different tools and techniques can be used in combination to capture the broader impact of vaccination in a way that is consistent with other health economic evaluations. In addition, more country level evidence is needed from low and middle income countries to justify future investments in vaccines and immunization programs. Finally, the proposed broader economic impact framework may contribute towards better communication of the economic arguments surrounding vaccine uptake, leading to investments in immunization by stakeholders outside of the traditional health care sector such as ministries of finance and national treasuries.

【 授权许可】

   
2012 Deogaonkar et al.; licensee BioMed Central Ltd.

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