The broader economic impact of vaccination: reviewing and appraising the strength of evidence

BMC Medicine

Joanne Yoong²  Safiyah Salim²  Jananie Audimulam²  Neisha Sundaram²  May Ee Png²  Raymond Hutubessy¹  Mark Jit³ 

[1] Initiative for Vaccine Research, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland;Saw Swee Hock School of Public Health, Tahir Foundation Building, National University of Singapore, 12 Science Drive 2, Singapore 117549, Singapore;Modelling and Economics Unit, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK

关键词: Vaccines;    Systematic review;    Immunisation;    Health economics;    Cost-effectiveness;   

Others  :  1223801
DOI  :  10.1186/s12916-015-0446-9

 received in 2015-05-02, accepted in 2015-08-11,  发布年份 2015

【 摘 要 】

Background

Microeconomic evaluations of public health programmes such as immunisation typically only consider direct health benefits and medical cost savings. Broader economic benefits around childhood development, household behaviour, and macro-economic indicators are increasingly important, but the evidence linking immunization to such benefits is unclear.

Methods

A conceptual framework of pathways between immunisation and its proposed broader economic benefits was developed through expert consultation. Relevant articles were obtained from previous reviews, snowballing, and expert consultation. Articles were associated with one of the pathways and quality assessed using modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria.

Results

We found 20 studies directly relevant to one or more pathways. Evidence of moderate quality from experimental and observational studies was found for benefits due to immunisation in improved childhood physical development, educational outcomes, and equity in distribution of health gains. Only modelling evidence or evidence outside the immunization field supports extrapolating these benefits to household economic behaviour and macro-economic indicators.

Conclusion

Innovative use of experimental and observational study designs is needed to fill evidence gaps around key pathways between immunisation and many of its proposed economic benefits.

【 授权许可】

   
2015 Jit et al.

【 图 表 】

Fig. 1.

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