September 12, 2011

Vaccinations in 72 poorest countries could avert 6.4 million deaths

By scaling up childhood vaccinations in 72 of the world’s poorest countries, an estimated 6.4 million deaths could be averted between 2011 and 2020, with a corresponding economic value of between $151 billion and $231 billion, according to two new studies by Johns Hopkins Bloomberg School of Public Health investigators published in the June issue of Health Affairs.

The new studies link the health benefits from projected increases in childhood immunization rates to both short- and long-term productivity gains, and consider the value of the lives of those at risk. International donors met recently in London to pledge funding for the GAVI Alliance, an international partnership that finances vaccines for children in these countries, and which faces a shortfall of approximately $3.7 billion.

“Together, these two studies demonstrate the wider economic benefits that can be achieved by expanding vaccine access during the Decade of Vaccines. They show why foundations and governments everywhere should make investments in vaccination a top priority,” said Orin Levine, associate professor in the Bloomberg School’s Department of International Health and director of the International Vaccine Access Center at Johns Hopkins.

Vaccines are among the most cost-effective public health interventions. The Bill & Melinda Gates Foundation has committed $10 billion over the next decade, known as the Decade of Vaccines (2011–2020), to increase access to childhood vaccines in the world’s poorest countries. During this period—scaling up the delivery of vaccination against pneumococcal disease, Haemophilus influenza type b, rotavirus, pertussis, measles and eventually malaria—the health benefits could be substantial, with an estimated 426 million cases of illness and 6.4 million deaths averted.

Researchers at the Bloomberg School used two approaches to forecast the potential economic value of the Decade of Vaccines.

In the first study, Meghan Stack, a research associate in International Health, and colleagues estimated the economic benefits to health systems and households. Beyond the vaccine-preventable illness and deaths that would be averted, expanding childhood immunization rates could result in $151 billion in treatment and productivity savings between 2011 and 2020. Stack’s analyses show that approximately $6.2 billion could be saved by not needing to pay for treatments when children are acutely ill; that approximately $1.2 billion in savings would be attributed to avoiding the lost productivity of parents while caring for their ill children; and that the largest savings, $145 billion, are from avoiding the productivity lost when children die young or are permanently disabled by vaccine-preventable diseases.

Vaccines against pneumonia (the pneumococcal and Hib vaccines) represent $68 billion (45 percent) of the total estimated savings in treatment costs and productivity losses, while accounting for 42 percent of the 6.4 million lives saved.

The second study in Health Affairs goes beyond direct medical costs and productivity loss to present the impact of the vaccine expansion in terms of the “value” of the lives saved.

This analysis by Sachi Ozawa, an assistant scientist in International Health, and colleagues represents the first use of the “value of statistical life” approach to estimate the value of averting deaths from vaccination in developing countries. This method, which is widely used by the U.S. government for analyses of health and environmental policies, estimates the value of saving a life by using data on how much income individuals are willing to trade in return for an increased or decreased risk of mortality. The study authors estimate the value to individuals living in high-risk countries of reducing death rates with this scaled-up vaccination program. The results put the value of the 6.4 million child deaths averted at $231 billion over 10 years.

Funding for the research was provided by the Bill & Melinda Gates Foundation.