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The Value of Vaccine Programs


Highlights from the Decade of Vaccine Economics (DoVE) study from the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health

To better understand the economic value of vaccines,Pentavalent, human papillomavirus (HPV), Japaneses encephalitis (JE), Measles, mumps, rubella (MMR), Meningococcal conjugate A (Men A), Pneumococcal conjugate, rotavirus (RV), yellow fever (YF) the Decade of Vaccine Economics (DoVE) project calculated the Return on Investment (ROI) of vaccine programs in 73 low- and middle-income countries.These 73 countries were supported by Gavi, the Vaccine Alliance, over the 2011-2020 period. DoVE also estimated the Cost of Illness (COI) for three vaccine-preventable diseases in Bangladesh and Uganda. Finally, in Bangladesh, DoVE measured people’s Willingness to Pay (WTP) to reduce their risk of vaccine-preventable disease.

All $ values presented are in 2018 USD

Study 1: Return on Investment

Learn how DoVE determined the Return on Investment of vaccine programs by comparing the costs to economic benefits.
Read the policy briefs
The Value of Vaccines (English) Importance des Programmes de Vaccinations (Français)

Two ways to show vaccines are a smart investmentROI calculations are for Gavi 73 countries from 2021-2030.

DoVE compared the costsThese costs include purchasing, storing, and delivering vaccines. of providing vaccines against 10 diseasesHaemophilus influenzae type b, hepatitis B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serotype A, Streptococcus pneumoniae, rotavirus, rubella, and yellow fever. to the economic benefits of vaccines in 73 low- and middle-income countries from 2021–2030.

Using a Cost of Illness approach, the estimated net benefit would be about 20 times the cost of vaccine programs. Using a Value of a Statistical Life approach, the net-benefit versus cost ratio for the same decade would be more than 50 to 1. By comparison, publicly traded American companies in the S&P 500 have returned an average of $2.16 for every $1 invested after 10 years.

Investment
Return on Investment (COI)
Return on Investment (VSL)

Cost of Illness (COI) approachThis approach adds up all the costs of diseases that are prevented by vaccination, including the money spent on treating an illness and lost caregiver wages. It also includes the worst-case scenario where the child is disabled or their life is cut short - which in economic terms results in lost worker productivity.

Investment Return on Investment

Value of Statistical Life (VSL) approachWe adjusted the U.S. VSL value to LMICs—including the 73 Gavi countries—using a standardized approach called the "value-transfer method." The value-transfer method adjusts VSL based on differences in income between LMICs and the U.S.

Investment Return on Investment

Economic benefits

We estimate that between 2021 and 2030, vaccine programs in 73 low- and middle- income countries
Countries studied in DoVE:
  • Afghanistan
  • Angola
  • Armenia
  • Azerbaijan
  • Bangladesh
  • Benin
  • Bhutan
  • Bolivia
  • Burkina Faso
  • Burundi
  • Cambodia
  • Cameroon
  • Central African Republic
  • Chad
  • Comoros
  • Congo
  • Congo, Dem. Rep.
  • Cote d'Ivoire
  • Cuba
  • Djibouti
  • Eritrea
  • Ethiopia
  • Gambia
  • Georgia
  • Ghana
  • Guinea
  • Guinea-Bissau
  • Guyana
  • Haiti
  • Honduras
  • India
  • Indonesia
  • Kenya
  • Kiribati
  • Korea, DPR
  • Kyrgyzstan
  • Lao PDR
  • Lesotho
  • Liberia
  • Madagascar
  • Malawi
  • Mali
  • Mauritania
  • Moldova
  • Mongolia
  • Mozambique
  • Myanmar
  • Nepal
  • Nicaragua
  • Niger
  • Nigeria
  • Pakistan
  • Papua New Guinea
  • Rwanda
  • Sao Tome and Principe
  • Senegal
  • Sierra Leone
  • Solomon Islands
  • Somalia
  • Sri Lanka
  • Sudan: North
  • Sudan: South
  • Tajikistan
  • Tanzania
  • Timor-Leste
  • Togo
  • Uganda
  • Ukraine
  • Uzbekistan
  • Viet Nam
  • Yemen
  • Zambia
  • Zimbabwe
will prevent over $782 billionCost of Illness represented approximately about 1% of GDP for a decade for all countries. VSL represented approximately about 2% of GDP for a decade for all countries. in costs associated with diseases.Using the Cost of Illness approach.
Countries studied in DoVE

The economic benefits of vaccine programs far outweigh their costs.

Total immunization program costs
Total economic benefits (COI)
Total economic benefits (VSL)

Cost of Illness (COI) approach

{{value}} billion
Costs include:
  1. Vaccine Procurement Costs
    • Vaccine Supply Costs
    • Freight
  2. Immunization Delivery Costs
    • Labor Costs
    • Storage Costs
    • Transportation Costs
    • Capital Costs
    • Management & Training Costs
 {{value}} billion
COI benefits include:
  1. Averted Medical Costs (Supplies & labor)
  2. Averted Transportation Costs
  3. Averted Caregiver Wages
  4. Productivity Loss due to disability & death

Value of Statistical Life (VSL) approach

{{value}} billion
Costs include:
  1. Vaccine Procurement Costs
    • Vaccine Supply Costs
    • Freight
  2. Immunization Delivery Costs
    • Labor Costs
    • Storage Costs
    • Transportation Costs
    • Capital Costs
    • Management & Training Costs
 {{value}} billion Willingness to Pay to reduce mortality risk may include the value people place on intangible aspects of life, such as leisure time, happiness, spending healthy time with friends and family, and passing knowledge to the next generation.

Calculate the return on an investment in vaccine programs

Dollars invested

Cost of Illness (COI) approach

Dollars invested Return on Investment

Value of Statistical Life (VSL) approach

Dollars invested Return on Investment
Read the ROI studies
Return On Investment From Immunization Against 10 Pathogens In 94 Low- And Middle-Income Countries, 2011–30 Economic Benefits of Immunization for 10 Pathogens in 94 Low- and Middle-Income Countries From 2011 to 2030 Using Cost-of-Illness and Value-of-Statistical-Life Approaches Costs of Immunization Programs for 10 Vaccines in 94 Low- and Middle-Income Countries From 2011 to 2030

Study 2: Cost of Illness

The costs of pneumonia, diarrhea and measles are significant. But many of these cases can be prevented with vaccination.

The majority of costs are borne by households, not governments; but the average cost of care for a single case is lowest at public facilities.

Societal cost of pneumonia, diarrhea and measles in children under 5

See results:
  • {{ label }}
Government
Household
Government
Household Caregiver direct medical cost
Household Caregiver direct non-medical cost
Household Caregiver indirect cost
  • {{ label }}
Data notes

The values represent the average cost of healthcare at public, private for profit (PFP) and private non for profit (PNFP) facilities per case.


There is currently no data for BANGLADESH:

  • Pneumonia - Inpatient - PNFP
  • Measles - Outpatient - PFP and PNFP
  • Measles - Inpatient - PFP
 Data notes

The Government covers some of the cost of healthcare at public facilities, including:

  • Capital cost
  • Overhead cost
  • Labor cost
  • Medications cost
  • Investigation and procedure cost

Caregivers cover:

  • Direct medical costs (medications, fees)
  • Direct non-medical costs (transportation to/from facilities, meals)
  • Indirect costs (loss of income due to missed days of work)
PFP = Private for profit PNFP = Private non for profit

These illnesses reinforce inequalities in the population.

The economic burden of healthcare weighs more heavily on caregivers from poorer households. They are more likely to have to take loans and borrow money to cope with the cost of care. Richer households can rely more easily on their savings and resources.

Catastrophic health expenditures and coping mechanisms

See results:
  • {{ label }}
Outpatient
Inpatient
  • {{ label }}
Data notes

A caregiver is experiencing catastrophic health expenditure when their out-of-pocket payments (direct medical + non-medical costs) is larger than 40% of their monthly expenses for the household* (rent, clothing, entertainment, etc.).

* Excluding food


Caregivers are grouped by quintiles based on their reported assets (furniture, water source, house construction materials, etc.).


To cope with healthcare costs, caregivers can use the money they have (currently or saved), sell their assets (cattle, land, vehicles), use donations from family and friends, and take a loan from a bank or micro-credit institution. These options can be combined.


There is currently not enough data available for:
Measles - Outpatient

Read the COI studies
Cost of Nine Pediatric Infectious Illnesses in Low- and Middle-Income Countries: A Systematic Review of Cost-of-Illness Studies The economic burden of measles in children under five in Uganda   The economic burden of measles in children under five in Bangladesh  

Study 3: Willingness to Pay

Willingness-to-Pay and Value of a Statistical Life: Results from a Pilot Study in Bangladesh

This section highlights the Value of a Statistical Life in 2019 USD elicited from the willingness-to-pay for a 1/3000 reduction in annual risk of death among 413 survey respondents of our pilot study in Bangladesh. Graph 1 compares the average elicited Value of a Statistical Life and compares it with the 2019 GDP per capita in Bangladesh. Graph 2 highlights the difference in Willingness to Pay for equally effective interventions called a "medication", "vaccine", and "intervention" respectively, indicating that framing matters significantly for eliciting willingness-to-pay.

Distribution of the Value of a Statistical Life for a 1/3000 risk reduction

GDP Per capita
Mean VSL
Number of people
Mean VSL$11,340 GDP Per capita$1,698

The Effect of Framing: Average Willingness-to-Pay for a 1/3000 risk reduction by Intervention Name

Intervention Name

Mean WTP

{{label}} {{value}}
Medication Vaccine Intervention

To learn more about the process involved in generating willingness to pay estimates, please refer to the contingent valuation manuscript below: