We have often stated here on SBM that vaccine programs are the most effective, and most cost-effective, public health measures in human history. They save lives, prevent disease, and save money. These benefits are all well researched and copiously documented. A recent CDC study adds to the literature on the benefits of vaccines and vaccine programs, focusing on the effects of the Vaccines for Children program (VFC) over the last 30 years.
We can start with the numbers from the CDC study, which are dramatic.
“Among children born during 1994–2023, routine childhood vaccinations will have prevented approximately 508 million cases of illness, 32 million hospitalizations, and 1,129,000 deaths, resulting in direct savings of $540 billion and societal savings of $2.7 trillion.”
These benefits are not surprising to anyone familiar with the vaccine literature. As one recent review summarized:
“By preventing episodes of vaccine-preventable diseases, vaccination can also help avert associated out-of-pocket medical expenses, healthcare provider costs, and losses in wages of patients and caregivers. Studies have associated vaccines positively with cognition and school attainment, suggesting benefits of long-term improved economic productivity. New evidence suggests that the measles vaccine may improve immunological memory and prevent co-infections, thereby forming a protective shield against other infections, and consequently improving health, cognition, schooling and productivity outcomes well into adolescence and adulthood in low-income settings.”
We can also add that vaccines which prevent bacterial diseases are effective in reducing antibiotic resistance. This highlights the potential downstream benefits of effective disease prevention.
It should also be noted that programs like the VFC are an important socioeconomic equalizer. There are lifelong benefits to cognitive function, overall health, and economic productivity from vaccines. The VFC pays for childhood vaccines for the roughly 54% of Americans who do not have insurance to cover vaccinations and may not be able to afford them. The program pays for “eligible children aged ≤6 years since the program began in 1994: diphtheria, tetanus, and pertussis (DTP, [later, acellular pertussis, DTaP]) vaccine; Haemophilus influenzae type b (Hib) vaccine; polio (oral poliovirus vaccine [OPV] then inactivated [injectable] poliovirus vaccine [IPV]); measles, mumps, and rubella (MMR) vaccine; and hepatitis B (HepB) vaccine.”
The benefits to society are massive, and the CDC numbers likely underestimate the true benefit as it is difficult to capture all the downstream effects. Let’s think about some of the specifics, like preventing 32 million hospitalizations. There is obviously the direct cost of this care, but also such illnesses put a strain on hospital systems, especially during outbreaks. This puts hospital workers at increased risk, and requires expensive and often tedious measures to reduce infection risk in patient care settings.
The VFC prevented over 1 million deaths, but over 500 million illnesses. How many of those illnesses would have resulted in morbidity – in reduced health that would have resulted in a lifetime of greater healthcare costs and reduced productivity?
The return on investment for society for vaccine programs is massive. There is also a quality of life issue. We are among the first generation of people not to live in a world in which it is not routine to lose one or more children to illness, or to have to watch our children suffer from preventable illnesses like polio. In the pre-vaccine era parents lived in constant, and well-founded, fear of such illnesses.
It is one of the great ironies of vaccines that they are a victim of their own success. They are so effective in preventing illness that today’s parents no longer live in fear of the diseases they prevent. This means they may have lost sight of the benefits of vaccines, and have nothing to balance out the fearmongering of anti-vaccine propaganda.
It is important to point all this out, and to put some quantitative heft behind the general statements of the benefits of vaccines. Of the three major presidential candidates this year, two are decidedly anti-vaccine. Trump, for example, promises to withhold funding for any schools with vaccine mandates. This would be disastrous policy with an enormous cost to society for generations.
Sometimes we do have to point out the obvious because people need to hear it. Vaccines are safe and effective. They have the greatest ROI of any healthcare intervention. They are an incredible investment in the health, prosperity, and quality of life of all citizens. We should do everything we can to maximize vaccine compliance, including mandates and subsidies.
