Table 1 Detailed descriptions of each proposed benefit of immunisation programmes
From: The broader economic impact of vaccination: reviewing and appraising the strength of evidence
Category | Definition | Outcome measures |
|---|---|---|
A. Health-related benefits to vaccinated individuals | ||
  A1. Health gains | Reduction in morbidity and mortality | Cases averted |
Deaths averted | ||
QALYs/DALYs saved | ||
  A2. Health care cost savings | Reduction in direct cost of health care borne by the public sector or private individuals | Costs saved by health care provider |
Health care costs saved by individuals | ||
B. Productivity-related benefits | ||
  B1. Productivity gains related to care | Reduction in lost days of work due to caring for a sick patient | Value of productivity |
  B2. Productivity gains related to health effects | Reduction in lost days of work due to sickness or death of a sick patient | Friction costs |
Potential lifetime earnings | ||
  B3. Productivity gains related to non-utility capabilitiesa | Increased lifetime productivity because of enhanced capabilities (such as improved cognition and educational attainment) not easily measured using utility-based preference measures | Educational outcomes |
Cognitive outcomes | ||
Potential lifetime earnings | ||
C. Community or health systems externalities | ||
  C1. Ecological effects | Health improvements in unvaccinated community members as a result of ecological effects such as herd immunity, eradication, and reduced antibiotic usage | Indirect vaccine protection |
Prevalence of antibiotic resistance | ||
Future cost of disease control averted | ||
  C2. Equity | More equal distribution of health outcomes | Distribution of health outcomes |
  C3. Financial and programmatic synergies and sustainability | Improved financial sustainability as a result of effects such as synergies with other health care programmes (e.g. delivery platforms), stimulation of private demand, and mechanisms to enhance group purchasing power (e.g. PAHO revolving fund) | Financial benefits |
Private demand estimates | ||
  C4. Household security | Improved financial security of households as a result of reduced risk of catastrophic expenditure | Actuarial value of security |
D. Broader economic indicators | ||
  D1. Changes to household behaviour | Economic improvements due to changes in household choices such as fertility and consumption/saving as a result of improved child health and survival | Productivity |
Female labour participation | ||
Household investment | ||
Child dependency ratio | ||
  D2. Public sector budget impact | Change to an individual’s net transfers to the national budget over his/her lifetime | Return on investment |
Net present value of investment | ||
  D3. Short-term macroeconomic impact | Changes to national income or production as a result of short-term exogeneous shocks to the economy | Change in GDP (per capita) |
Change in sectoral output | ||
  D4. Long-term macroeconomic impact | Changes to national income or production as a result of long-term changes to drivers such as labour supply and foreign direct investment | Change in GDP (per capita) |