Vaccination against childhood communicable diseases through the Expanded Program on Immunization (EPI) is one of the most cost-effective public health interventions available (UNICEF 2002; World Bank 1993). By reducing mortality and morbidity, vaccination can contribute substantially to achieving the Millennium Development Goal of reducing the mortality rate among children under five by two-thirds between 1990 and 2015. Accelerated research into the development of new vaccines has been made possible in part by innovative public-private partnerships, such as the Global Alliance for Vaccines and Immunization (GAVI). GAVI focuses on expanding access by immunization programs in developing countries to new and underused vaccines, such as those for hepatitis B and Haemophilus influenzae type B (Hib). These newer, more expensive vaccines are challenging previous notions of the cost-effectiveness of immunization. Analyses of their costs and cost-effectiveness are particularly important because of the need to determine the level of resources required in the future to improve immunization programs, to cover the costs of new vaccines, and to allocate scarce public and external resources available for immunization in the most optimal manner.
This chapter analyzes the costs and cost-effectiveness of scaling up the EPI and introducing selected new vaccines into the program. It also summarizes the epidemiology of diseases preventable through immunization and estimates the disease burden with and without immunization programs. In addition, the chapter discusses the organization, delivery, and financing of immunization programs and highlights future prospects and areas for further study.
Copyright © 2006, The International Bank for Reconstruction and Development/The World Bank Group.