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
| Perspective | Benefit categories | Definition | |
| Broad | Narrow | Health care cost savings | Savings of medical expenditures because vaccination prevents illness episodes |
| Care-related productivity gains | Savings of patient’s and caretaker’s productive time because vaccination avoids the need for care and convalescence | ||
| Outcome-related productivity gains | Increased productivity because vaccination improves physical or mental health | ||
| Behavior-related productivity gains | Vaccination improves health and survival, and may thereby change individual behavior, for example by lowering fertility or increasing investment in education | ||
| Community health externalities | Improved outcomes in unvaccinated community members, e.g., through herd effects or reduction in the rate at which resistance to antibiotics develops | ||
| Community economic externalities | Higher vaccination rates can affect macroeconomic performance and social and political stability | ||
| Risk reduction gains | Gains in welfare because uncertainty in future outcomes is reduced | ||
| Health gains | Utilitarian value of reductions in morbidity and mortality above and beyond their instrumental value for productivity and earnings | ||