March 14, 2014 Kim Krisberg 1Comment

It’s not the first study to examine the enormous health and economic benefits of vaccines. But it’s certainly another impressive reminder about the power — and value — of prevention.

In a study published online earlier this month in the journal Pediatrics, researchers found that childhood immunizations among babies born in 2009 will prevent 42,000 early deaths and 20 million cases of disease, saving the nation $13.5 billion in directs costs (medical costs and disease outbreak control) and more than $68 billion in total societal costs (premature death and lost productivity). That means that every $1 spent on vaccines ultimately saves at least $10. The study was based on the 2009 routine U.S. childhood immunization schedule (with the exception of the flu shot), vaccination coverage rates, historical data on disease incidence before vaccination, and disease reports between 2005 and 2009.

The study follows a similar study published in 2005 that examined the benefits of the 2001 routine childhood immunization schedule and which also found enormous economic benefits to vaccination. In fact, even though the expanded 2009 immunization schedule costs more to deliver, it still saved billions more dollars when compared to 2001. Authors Fangjun Zhou, Abigail Shefer, Jay Wenger, Mark Messonnier, Li Yan Wang, Adriana Lopez, Matthew Moore, Trudy Murphy, Margaret Cortese and Lance Rodewalk wrote:

Although increased cost of vaccines combined with increased administrative and travel costs led to an increase in program costs of $4.7 billion in 2009 (from $2.8 billion in 2001 to $7.5 billion in 2009), the program achieved additional savings of nearly $30 billion compared with costs averted in 2001.

In addition, the study found that because current levels of vaccine-preventable disease are so low in the United States, even modeling a 10-fold increase in disease incidence didn’t change the current benefit-cost ratio of 10-to-1 in a substantial way. They also modeled an increase in vaccine-related adverse events and still came up with a positive benefit-cost ratio. (The risk of a serious vaccine-related adverse event is extremely low and most adverse events are minor, such as soreness at the injection site or a mild fever.)

The authors did state that although vaccines saved more money in 2009, the benefit-cost ratio was lower than it was in 2001. They attributed this to three new immunizations — the hepatitis A vaccine, rotavirus vaccine and pneumococcal conjugate vaccine — and the diseases they prevent. In other words, the diseases are less likely to result in long hospitalizations and death and so their benefit-cost ratios are not very large. But, as with many public health and prevention interventions, their value can’t be entirely calculated in dollars and cents. The study estimated that the three newer vaccines will still prevent about 4 million cases of disease and 5,000 deaths. And estimated direct and indirect cost savings still totaled a whopping $3 billion.

The study noted that while the U.S. is home to high childhood immunization rates, underinsured children may not always enjoy the same kind of access to life-saving vaccines as children with private insurance. Luckily, the Affordable Care Act (ACA) aims to level the playing field. Under the health reform law, all private insurers participating in the federal and state-based health insurance marketplaces must cover federally recommended vaccines without cost sharing. And collecting data on the ACA policy and its impact on vaccine uptake could provide valuable insight during vaccine financing debates, the study stated.

“Our data confirm that the vaccines currently recommended for young children represent not only a major public health victory in terms of disease prevention, but also an excellent public health ‘buy’ in terms of dollars and cents,” the authors wrote.

According to 2012 data from the Centers for Disease Control and Prevention, about 90 percent of  U.S. children ages 19 to 35 months old received recommended immunizations and less than one percent received no vaccinations at all.

Visit Pediatrics for a full copy of the study.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.

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