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The Economic Case for Expanding Vaccination Coverage of Children

By David Bloom, et al. 

Short Summary

Part of the 2009 Best Practice Papers project, lead author David Bloom lays out the case for expanding childhood vaccination programs. He draws on his work and the published results of Copenhagen Consensus 2008 research. 

Childhood vaccination programs have had a dramatic impact on child morbidity and mortality worldwide. A universal effort to extend vaccination coverage to all children began in 1974, when the World Health Organization founded the Expanded Program on Immunization. This initiative helped countries establish the infrastructure needed to introduce and deliver a standard vaccine package, which in 1974 included the vaccine against diphtheria-tetanus-pertussis (DTP), measles-containing vaccine (MCV), polio vaccine (Pol), and Bacillus Calmette-Guérin (BCG) vaccine. 

Despite the longstanding availability of EPI vaccines and national health policies aiming at universal or near universal coverage, actual coverage is widely incomplete. Incomplete coverage of vaccinations, in turn, leads to large numbers of avoidable child deaths.  

Benefit-Cost analyses of vaccination programs have usually focused on gains in health, health care costs, and the time costs of parents taking care of their sick children.  However, a new understanding of the linkages between health and wealth, and of vaccine-related externalities, suggests that this understanding of vaccine-related benefits is incomplete and neglects a number of long term individual- and population-level gains. Approaching BCA of vaccination from a broad perspective that accounts for these additional gains invites a new and more comprehensive conceptualization of the benefits of vaccination.