15 de juny 2015

The value of vaccination

Valuing vaccination

A PNAS article sets a broader perspective on valuing vaccines. It is of interest in light of current difteria case. My position is clear, no doubt about mandatory vaccination if its cost-effectiveness is proven.
Suggestions from the article:
Three general recommendations flow from our arguments and related synthesis of existing evidence on broad benefits of vaccination. First, many economic evaluation studies of vaccinations should be redone to capture the full benefits generated by the vaccination in question. Second, the evidence to date on the full value of vaccination has been focused on measuring the total social benefits generated. It would also be useful to explore the distribution of vaccination’s benefits among different possible beneficiaries. Third, the primary empirical evidence on broad vaccination benefits will need to be considerably expanded and improved

Framework of vaccination benefits
PerspectiveBenefit categoriesDefinition
BroadNarrowHealth care cost savingsSavings of medical expenditures because vaccination prevents illness episodes
Care-related productivity gainsSavings of patient’s and caretaker’s productive time because vaccination avoids the need for care and convalescence
Outcome-related productivity gainsIncreased productivity because vaccination improves physical or mental health
Behavior-related productivity gainsVaccination improves health and survival, and may thereby change individual behavior, for example by lowering fertility or increasing investment in education
Community health externalitiesImproved outcomes in unvaccinated community members, e.g., through herd effects or reduction in the rate at which resistance to antibiotics develops
Community economic externalitiesHigher vaccination rates can affect macroeconomic performance and social and political stability
Risk reduction gainsGains in welfare because uncertainty in future outcomes is reduced
Health gainsUtilitarian value of reductions in morbidity and mortality above and beyond their instrumental value for productivity and earnings