Vaccination: the cornerstone of an efficient healthcare system

Figures & data

Fig. 1. Comparison of the estimated annual morbidity in the United States in the pre- and post-vaccine eras (7).

Table 1. Number of reported cases of vaccine-preventable diseases in the European region based on data from the WHO vaccine-preventable disease monitoring system

	1980	2000	2011	2012	2013
Diphtheria	608	1,585	33	32	32
Measles	851,849	37,421	37,073	26,982	25,375
Mumps	No data	243,344	27,448	38,141	35,075
Pertussis	90,546	53,675	34,432	56,941	27,824
Polio	549	0	0	0	0
Rubella	No data	621,039	9,672	30,509	39,614
Rubella (CRS)	No data	48	7	60	50
Tetanus	1,715	412	197	194	93

From Refs (9, 11).

CRS: congenital rubella syndrome; Full database available in Ref. (11).

Table 2. Direct and indirect savings from vaccination

Disease	Comparative savings	Direct or indirect savings (US$)
Smallpox^a	NA	300 million in direct costs per year
Polio^b	NA	13.6 billion in total savings world wide by 2040 700 million in the United States between 1991 and 2000
Measles	Treating one child with measles costs 23 times the cost of vaccinating one child against measles	10 per disability-adjusted life-year (DALY)
Cholera	NA	770 million lost in seafood exports in Peru, 1991
Malaria	NA	100 billion GDP lost annually in sub-Saharan Africa
MMR	For every US$ spent on MMR vaccine, more than US$21 is saved in direct medical care costs	100 million in direct medical costs from 1989 to 1991 for measles outbreaks
DTaP	For every US$ spent on DTaP vaccine, US$24 is saved	23.6 billion in direct and indirect costs without DTaP vaccines
Hib	For every US$ spent on Hib vaccine, more than US$2 is saved	5 billion in direct costs and 12 billion in indirect costs incurred in the United States

From Ref. (13).

NA: not available; MMR: measles–mumps–rubella; DTaP: diphtheria–tetanus–acellular pertussis; Hib: H. influenzae type b.

^aBased on eradication of smallpox in 1977; ^bbased on eradication of polio by 2005; calculation details available in Ref. (13).

Table 3. Summary of an economic evaluation of the routine childhood vaccination programme in the US in 2009

Childhood vaccination programme	Payer perspective	Societal perspective
Costs saved	20.3	76.4
Costs of routine immunization programme	6.7	7.5
Net cost savings	13.5	68.8
Benefit–cost ratio	3.0	10.2

Costs are given as 2009 billion US$.

Note: Calculations based on population-based vaccination coverage, published vaccine efficacies, historical data on disease incidence before vaccination, and disease incidence reported during 2005–2009. Programme costs included vaccine, administration, vaccine-associated adverse events, and parent travel and work time lost. Three percent annual discount rate (15).

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