Fiscal analysis of the pediatric immunization program in Belgium applying a lifetime government perspective framework

Figures & data

Table 1. Data inputs for the calculation of fiscal consequences.

Parameter	Value	Source
Indirect tax burden (taxes based on consumption e.g. sales tax, VAT)	21.0%	[18]
Direct tax burden (captures taxation of wages and social insurances)	52.0%	[19]
Disposable income as % of gross income (portion of income spent on consumable products and services that are subject to indirect taxes i.e. VAT)	59.0%	[20]
Annual disability cost (adults <65 years of age)^†	€15,250.89	[21]
Annual disability cost (<18 years of age, children/adolescents)	€5,373.73	[22]
Duration of adolescent disability benefits payments (years receiving benefit)	19	w.a.
Excess annual educational costs per pupil with cognitive disability^‡	€38,983	[23]
Starting age of special educational needs (years of age)	5	[24]
Duration of special education (number of years receiving special education)	18	[24]
Average annual old-age state pension (adults ≥67 years of age)	€19,808.04	[25]
Reduction (loss) of economic activity for individuals with any disability (measles, polio, meningitis C)	33.79%	[26]
Reduction (loss) of earnings for individuals with cognitive disability(applies to Hib, rubella)	33.79%	[26]
Reduction (loss) of earnings for individuals with hearing loss (applies to Hib, pneumococcal, meningitis C)	25.6%	[27]
Reduction of economic activity for individuals with hearing loss (Hib, pneumococcal, meningitis C)	29.2%	[28]
Epilepsy-related loss of economic activity (applies to meningitis C)	12.7%	[29]
Renal failure-related loss of activity (applies to meningitis C)	28.0%	[30]
Major paralysis: Reduction (loss) of economic activity. (applies to polio)	100%	wa
Neurological defect-related loss of economic activity (applies to meningitis C)	0.0%	[31]
Amputation-related loss of economic activity (applies to meningitis C)	0.0%	[32]

Note: wa: working assumption; ^†This represents the amount of income support paid by government annually to support a disabled person. ^‡applied to every year of schooling for the proportion of children that became cognitively impaired due to infectious conditions.

Table 2. Lifetime fiscal impact of pediatric immunization in Belgium from single birth cohort societal and fiscal perspectives base year 2020 (€ discounted in 2020 million (M)).

		Fiscal perspective
	Societal perspective	Averted tax revenue loss and public costs				Longevity costs
Vaccination^†	Gross earnings gain (averted losses)	Averted tax revenues loss	Averted disability transfers cost	Averted special education costs	Disease-related healthcare savings	Unrelated healthcare costs, i.e. Medicare age > 64	Retirement pensions’ costs
Diphtheria	20.55 M	13.27 M	–	–	0.89 M	2.28 M	3.65 M
Tetanus	3.27 M	2.11 M	–	–	2.73 M	0.40 M	0.68 M
Pertussis	1.53 M	0.99 M	–	–	0.80 M	0.15 M	0.16 M
Hib	4.74 M	2.75 M	2.00 M	3.28 M	9.98 M	0.24 M	0.23 M
Measles	36.95 M	23.75 M	2.01 M	–	19.18 M	3.57 M	3.74 M
Mumps	–	–	–	–	36.96 M	–	–
Rubella	0.07 M	0.04 M	–	–	4.62 M	–	–
Pneumococcal	11.21 M	7.59 M	2.14 M	2.69 M	24.32 M	2.21 M	4.83 M
Polio	3.24 M	2.02 M	0.34 M	–	17.53 M	0.29 M	0.47 M
Rotavirus	0.49 M	0.32 M	–	–	7.23 M	0.05 M	0.05 M
Meningitis C	5.05 M	3.22 M	1.52 M	0.27 M	1.48 M	0.49 M	0.60 M
Total	88 M	56 M	8 M	6 M	126 M	10 M	14 M

^†Changes in HepB cases excluded.

Figure 1. Sensitivity analysis exploring impact of changes on the fiscal benefit-cost ratios (fBCR) excluding costs of longevity.

Figure 2. Sensitivity analysis exploring impact of changes on the fiscal benefit-cost ratios (fBCR) including longevity.

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Data availability statement

The data on which this study are based have been derived from publicly available sources. No proprietary data has been used in this modeling work. All sources used for conducting this analysis have been cited and where the necessary links are available. No individual patient or named person data is used in our work.