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The value of vaccination

Summary

David E. Bloom, David Canning and Mark Weston were the joint authors of a remarkable article published in the ‘World Economics’ journal in 2005 under the title ‘The Value of Vaccination’. In this article the value of vaccination is discussed from a wide perspective. Vaccination has proved its effectiveness from the pharmaco-economic standpoint. More importantly, it is a very efficient way of improving the health of populations. The authors also forecast that vaccination will be capable of achieving even better results in the future and that new and additional efforts will be needed in order for that potential to be realised.

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Vaccines are one of the most popular preventive intervention worldwide. Since the beginning of the 20th century, the wide use of vaccination has produced substantial achievements in the control of vaccine preventable diseases. Major victories against disease have been won by vaccination, eradicating a disease or reducing its incidence to rare case reports. The economic, medical and social importance of vaccines lies partly in the burden of disease that can be avoided and partly in the competition for resources between vaccines and other interventions (e.g. drugs, other preventive measures). Since World War II vaccination has had a major impact on global health.
In 2000 the Global Alliance for Vaccines and Immunization (GAVI) was launched. GAVI comprises United Nations agencies, governments, donors, foundations, private companies, and academic institutions. GAVI wants to improve the access to sustainable immunization services, and expand the use of all existing safe and cost-effective vaccines. GAVI supports the national and international accelerated disease control targets for vaccine-preventable diseases. An important objective is to make immunization coverage a centrepiece in international development efforts.

Lost momentum

The rapid progress towards universal vaccination coverage in the 1970s and 1980s has slowed in recent years. Developing countries lag behind developed countries in terms of vaccination coverage. Measles immunization rates are over 90 per cent in Europe but below 70 per cent in South Asia and below 60 per cent in sub-Saharan Africa.
Declining funding for immunization led to stagnating or falling coverage. UNICEF funding for vaccination fell from $182 million to $51.4 million between 1990 and 1998.
There are also many practical and political problems impeding optimal vaccination coverage. Delivering vaccines often requires functioning freezers or refrigerators; reliable transport to move the vaccines from delivery site to clinic; parents who realise the value of vaccination; trained medical staff to deliver the dose; and sterile syringes. It is not a surprise that political disruptions have affected coverage in some areas. Another reason for the lost momentum relates to public perceptions of vaccination. As coverage spreads through a community, it reaches a point at which those who are unvaccinated are highly unlikely to catch a disease because herd immunity has set in. In societies where vaccine-preventable disease prevalence is minimal as a result of past immunization efforts, the side effects of vaccines pose a greater health threat than the diseases themselves, since the diseases are no longer prevalent. Also, the rise of anti-vaccine movements has successfully persuaded some parents not to immunize their children.

Health improves wealth

Vaccination is providing the opportunity to eliminate or significantly reduce common infectious diseases, to save lives and to reduce human suffering. Economic evaluations indicate that many vaccination programs are cost-saving or cost-effective from the societal perspective.
There are several channels through which health improves wealth. The first is through its impact on education. Healthy children are better able to attend school and to learn effectively while in class.
Studies have found that health interventions such as de-worming programs and iron supplementation reduce absenteeism from school. The second channel is through the impact of health on productivity.
Like schoolchildren, healthier workers have better attendance rates and are more energetic and mentally robust. Bloom et al. have calculated that a one-year increase in life expectancy improves labour productivity by 4 per cent. The third way by which health improves wealth is through its effect on savings and investment.
Healthier people expect to live longer, so they have a greater incentive to save for retirement. The savings booms in the East Asian “tiger” economies in the last quarter of the 20th century were largely driven by rising life expectancy and greater savings for retirement. Finally, health can boost economies via a demographic dividend. The transition from high to low rates of mortality in many developing countries has been rapid. Largely brought about by medical and dietary improvements, the transition has contributed to a decreased rate of procreation, as parents realize they need fewer children to attain their ideal family size. Parents with fewer children can concentrate their resources in nurturing fewer children, thus increasing the children’s prospects of receiving a good education and effective health care.

Source: Advances in Vaccinology - October 15th, 2012 (last updated)