Abstract
ABSTRACT Objectives The economic evaluation of vaccines has attracted a great deal of controversy. In the academic literature, several vaccination advocates argue that the evaluation frame for vaccines should be expanded to give a more complete picture of their benefits. We seek to contribute to the debate and facilitate informed dialogue about vaccine assessment using visualization, as able to support both deliberation by technical committees about the substance of evaluation and communication of the underlying rationale to non-experts. Methods We present two visualizations, an Individual Risk Plot (IRP), and a Population Impact Plot (PIP), both showing the beneficiary population on one axis and the degree of individual benefit and cost of an individual dose on the second axis. We sketch out such graphs for 10 vaccines belonging to the UK routine childhood immunization schedule and present our own analysis for the rotavirus and meningitis B vaccines. Results While the IRPs help classify diseases by morbidity and mortality, the PIPs display the health and economic loss averted after introducing a vaccine, allowing further comparisons. Conclusion The visualizations presented, albeit open to provide an increasingly complete accounting of the value of vaccination, ensure consistency of approach where comparative judgments are most needed.
Highlights
Vaccination has an enormously successful track record in pub lic health
We present two plots, an Individual Risk Plot (IRP) and a Population Impact Plot (PIP)
A series of IRPs is produced for a list of diseases, where the QALY losses and mortality rates can be found in Appendix B of [4]
Summary
Vaccination has an enormously successful track record in pub lic health. Diseases which were previously a scourge in even the most developed countries are a distant memory. Not all vaccines merit deployment every where This may be because of the local disease burden: there is no need for universal dengue vaccination in the west of Scotland, for example, as the climate is inhospitable to Aedes aegypti and Aedes albopictus which are the principal vector for this disease. Several commentators have highlighted the limita tions of current evaluation frameworks in accounting for the range of benefits flowing from immunization programs. Previous valuations, it is argued, failed to reflect the full magnitude of the overall health, social and economic out comes of vaccines, and focused heavily on a narrow subset of factors, that present fewer methodological challenges and for which there is greater data availability. Socalled ‘health spill overs’, given that health-related conse quences (e.g. physical or emotional strain, anxiety, grief) accompany productivity losses for those who take on caring responsibilities within the social network surrounding ill indi viduals, could be considered
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