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Evaluating vaccination policy

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Vaccines as a positive externality[1]

The promotion of high levels of vaccination produces the protective effect of herd immunity[2] , as well as positive externalities in society. [3][4]

Vaccinations are public goods[5], they are both non-rivalrous and non-excludable[6], and given these traits, individuals may avoid the costs of vaccination by “free-riding” [3] off the benefits of others being vaccinated.[3][7][8] The costs and benefits to individuals and society have been studied and critiqued in stable and changing population designs.[9][10] [11] Other surveys have indicated that free-riding incentives exist in individual decisions[12] and in a separate study that looked a parental vaccination choice, the study found that parents were less likely to vaccinate their children if their children’s friends had already been vaccinated.[13] The free-rider problem inherent to vaccinations as a public good is important to public health policy makers when assessing policy options.

Cost-benefit analysis for population-level vaccination programs—United States

Since the first economic analysis of routine childhood immunizations in the United States in 2001 that reported cost savings over the lifetime of children born in 2001[14], other analyses of the economic costs and potential benefits to individuals and society have since been studied, evaluated, and calculated[15][3]. In 2014, the American Academy of Pediatrics published a decision analysis that evaluated direct costs (program costs such as vaccine cost, administrative burden, negative vaccine-linked reactions, and transportation time lost to parents to seek health providers for vaccination).[15] The study focused on diphtheria, tetanus, pertussis, Haemophilus influenza type b conjugate, poliovirus, measles/mumps/rubella (MMR), hepatitis B, varicella, 7-valent pneumococcal conjugate, hepatitis A, and rotavirus vaccines, but excluded influenza.[15] Estimated costs and benefits were adjusted to 2009 dollars and projected over time at 3% annual interest rate.[15] Of the theoretical group of 4,261,494 babies beginning in 2009, that had regular immunizations through childhood in accordance with the Advisory Committee on Immunization Practices guidelines “will prevent ∼42 000 early deaths and 20 million cases of disease, with net savings of $13.5 billion in direct costs and $68.8 billion in total societal costs, respectively.” [15] In the United States, and in other nations [16][17][18], there is an economic incentive and "global value" to invest in preventive vaccination programs, especially in children as a means to prevent early infant and childhood deaths.[19]

  1. ^ "Externality". Wikipedia. 2016-10-24.
  2. ^ "Herd immunity". Wikipedia. 2016-10-26.
  3. ^ a b c d Ibuka, Yoko; Li, Meng; Vietri, Jeffrey; Chapman, Gretchen B.; Galvani, Alison P. (2014-01-24). "Free-Riding Behavior in Vaccination Decisions: An Experimental Study". PLOS ONE. 9 (1): e87164. doi:10.1371/journal.pone.0087164. ISSN 1932-6203. PMC 3901764. PMID 24475246.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  4. ^ "Externality". Wikipedia. 2016-10-24.
  5. ^ "Public good". Wikipedia. 2016-11-02.
  6. ^ "Rivalry (economics)". Wikipedia. 2016-10-24.
  7. ^ Stiglitz, Joseph (2000). Economics of the Public Sector. Territory Rights: Worldwide. ISBN 978-0-393-96651-0.
  8. ^ Serpell, Lucy; Green, John (2006-05-08). "Parental decision-making in childhood vaccination". Vaccine. 24 (19): 4041–4046. doi:10.1016/j.vaccine.2006.02.037. ISSN 0264-410X. PMID 16530892.
  9. ^ Francis, Peter J. (1997-02-01). "Dynamic epidemiology and the market for vaccinations". Journal of Public Economics. 63 (3): 383–406. doi:10.1016/S0047-2727(96)01586-1.
  10. ^ Deogaonkar, Rohan; Hutubessy, Raymond; van der Putten, Inge; Evers, Silvia; Jit, Mark (2012-01-01). "Systematic review of studies evaluating the broader economic impact of vaccination in low and middle income countries". BMC Public Health. 12: 878. doi:10.1186/1471-2458-12-878. ISSN 1471-2458. PMC 3532196. PMID 23072714.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  11. ^ Francis, Peter J. (2004-09-01). "Optimal tax/subsidy combinations for the flu season". Journal of Economic Dynamics and Control. 28 (10): 2037–2054. doi:10.1016/j.jedc.2003.08.001.
  12. ^ Oraby, Tamer; Thampi, Vivek; Bauch, Chris T. (2014-04-07). "The influence of social norms on the dynamics of vaccinating behaviour for paediatric infectious diseases". Proceedings of the Royal Society B: Biological Sciences. 281 (1780). doi:10.1098/rspb.2013.3172. ISSN 0962-8452. PMC 4078885. PMID 24523276.
  13. ^ Meszaros, Jacqueline R.; Asch, David A.; Baron, Jonathan; Hershey, John C.; Kunreuther, Howard; Schwartz-Buzaglo, Joanne. "Cognitive processes and the decisions of some parents to forego pertussis vaccination for their children". Journal of Clinical Epidemiology. 49 (6): 697–703. doi:10.1016/0895-4356(96)00007-8.
  14. ^ Zhou, Fangjun; Santoli, Jeanne; Messonnier, Mark L.; Yusuf, Hussain R.; Shefer, Abigail; Chu, Susan Y.; Rodewald, Lance; Harpaz, Rafael (2005-12-01). "Economic Evaluation of the 7-Vaccine Routine Childhood Immunization Schedule in the United States, 2001". Archives of Pediatrics & Adolescent Medicine. 159 (12). doi:10.1001/archpedi.159.12.1136. ISSN 1072-4710.
  15. ^ a b c d e Zhou, Fangjun; Shefer, Abigail; Wenger, Jay; Messonnier, Mark; Wang, Li Yan; Lopez, Adriana; Moore, Matthew; Murphy, Trudy V.; Cortese, Margaret (2014-04-01). "Economic Evaluation of the Routine Childhood Immunization Program in the United States, 2009". Pediatrics. 133 (4): 577–585. doi:10.1542/peds.2013-0698. ISSN 0031-4005. PMID 24590750.
  16. ^ Gargano, Lisa M.; Tate, Jacqueline E.; Parashar, Umesh D.; Omer, Saad B.; Cookson, Susan T. (2015-01-01). "Comparison of impact and cost-effectiveness of rotavirus supplementary and routine immunization in a complex humanitarian emergency, Somali case study". Conflict and Health. 9: 5. doi:10.1186/s13031-015-0032-y. ISSN 1752-1505. PMC 4331177. PMID 25691915.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  17. ^ van Hoek, Albert Jan; Campbell, Helen; Amirthalingam, Gayatri; Andrews, Nick; Miller, Elizabeth. "Cost-effectiveness and programmatic benefits of maternal vaccination against pertussis in England". Journal of Infection. 73 (1): 28–37. doi:10.1016/j.jinf.2016.04.012.
  18. ^ Diop, Abdou; Atherly, Deborah; Faye, Alioune; Sall, Farba Lamine; Clark, Andrew D.; Nadiel, Leon; Yade, Binetou; Ndiaye, Mamadou; Cissé, Moussa Fafa. "Estimated impact and cost-effectiveness of rotavirus vaccination in Senegal: A country-led analysis". Vaccine. 33: A119–A125. doi:10.1016/j.vaccine.2014.12.065.
  19. ^ Ehreth, Jenifer (2003-01-30). "The global value of vaccination". Vaccine. Vaccines and Immunisation 2003. Based on the Third World Congress on Vaccines and Immunisation. 21 (7–8): 596–600. doi:10.1016/S0264-410X(02)00623-0.