Although new vaccines are more costly than traditional ones, they are overwhelmingly cost-effective

Washington, D.C., 11 May 2015 (PAHO/WHO) — Immunization programs have become increasingly costly in recent years as a result of the introduction of new vaccines and an expanding number of recommended target groups. Even so, immunization remains cost-effective and should continue to be considered a public health "best buy," according to a new series of studies published by the scientific journal Vaccine.

The new studies appear in a special Vaccine supplement titled "Expanding the Evidence Base to Inform Vaccine Introduction: Program Costing and Cost-Effectiveness Analyses." The series was coordinated by the Pan American Health Organization/World Health Organization (PAHO/WHO) as part of the ProVac initiative to provide evidence to support policy decisions on vaccine programs.

The studies, based on country-led research from around the world, show that with few exceptions, newer vaccines—including pneumococcal, rotavirus, and human papillomavirus (HPV) vaccines—are cost-effective in countries where there is a substantial disease burden or where treatment costs are high, or both, and if the vaccines can be procured at favorable prices.

immunization campaign

The studies that assessed immunization costs and financing, resulting from an initiative led by the Bill and Melinda Gates foundation, also show that, overall, governments are providing more financing for national immunization programs than previously reported, such that the lion's share of funding for these programs currently comes from national resources. The participating researchers in this EPIC initiative — EPI costing and financing -- developed and implemented a common approach to costing and formed a community of practice around cost and financial analysis of immunization.

The supplement includes 31 original research articles, nine of which are from the Americas (from Argentina, Belize, Brazil, Honduras, Paraguay and Peru), and four perspective articles by global experts in health economics and decision science. The original research includes 14 country-led cost-effectiveness analyses and nine country costing and financial flows analyses that incorporate new data collected from over 300 primary health care facilities in six countries. The four perspective articles address subjects including the potential role of cost-effectiveness analysis in vaccine price negotiations, the continued need for models and methodological approaches that can be adapted for use in low resource policy settings, and the challenges of supporting country-level decision making in the context of donors' priority setting.

"The country-led cost-effectiveness studies give an important update on the experiences of different countries with new vaccines," said Cuauhtemoc Ruiz, Chief of the Comprehensive Family Immunization Unit at PAHO/WHO. "The supplement also provides insights into the work that is needed to help countries strengthen policy making through the use of cost-effectiveness analyses, program costing analyses, and financial flows analyses."

The new supplement is the second to be published by Vaccine and coordinated by PAHO's ProVac initiative, which seeks to strengthen and institutionalize country capacity to generate, assess, interpret, and use local data in decision making about immunization programs and vaccine adoption.

"Accelerating national policy development on the adoption of vaccines is an issue of growing importance since newer vaccines come with higher price tags and compete with other new technologies and interventions for space in already constrained national health budgets," said Ruiz.

The Region of the Americas has been a leader in the introduction of new vaccines. Currently 19 of the region's countries use the rotavirus vaccine, 28 use the pneumococcus vaccine, and 16 use the HPV vaccine. Despite the higher costs of these vaccines, these countries have successfully introduced sustainability plans for these vaccines and financed their introduction with >99% of resources originating from public funds.

The ProVac Initiative has supported countries in the Americas in their immunization policymaking and resource allocation processes for the past 10 years. Recently, a pilot initiative to transfer the tools and knowledge developed by ProVac in the Americas to other Regions was implemented with the support of partners in the African, Eastern Mediterranean and European WHO Regions. This platform — the ProVac International Working Group — was coordinated by PAHO and implementing partners, including Sabin Vaccine Institute, the US Centers for Disease Control, the Agence de Medicine Preventive and PATH.

ProVac partners who contributed to the Vaccine supplement include the ProVac International Working Group, the Bill and Melinda Gates Foundation-led Multi-country Costing and Financing of Routine Immunization and New Vaccines (EPIC) Initiative, and the Sabin Vaccine Institute.

The supplement is available online to Vaccine subscribers via the journal's website. PDFs of the individual articles will be available to the public on the PAHO website.

Webinar launch

A webinar will be held on Tuesday 12 May 2015 to launch the supplement and provide an open forum for discussion with the editorial team and authors. The virtual meeting will begin at 10 am EDT and can be accessed at: (meeting number 644 958 166, password ProVac) in English. Participants are also welcome to attend in person at PAHO Headquarters (Room C), 525 23rd St. N.W., corner of Virginia Ave. N.W., in Washington D.C.


PAHO, founded in 1902, is the oldest international public health organization in the world. It works with its member countries to improve the health and the quality of life of the people of the Americas. It also serves as the Regional Office for the Americas of WHO.


Vaccine supplement

PROVAC relevant publications by year