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Not vaccinating is expensive. Not only does it negatively affect the population, but it also affects health systems. And that’s it vaccination has a double benefit: in addition to being one of the public health measures that has contributed most to the reduction of the incidence of communicable diseases and to the control of immune-preventable diseases, it represents a great economic savings for health systems, thus contributing to their sustainability.
In addition, vaccination is convenient. “Vaccines directly reduce the costs of medical care, many of which are hospital-type,” he tells GACETA MÉDICA. David Cantarero, Head of the Research and Development Group in Health Economics at the Valdecilla Health Research Institute (IDIVAL). “Approximately, for every euro spent on vaccines savings from 4 to 5 euros on direct medical expenses“, Insert. And if we consider the indirect costs, the figure would increase even more.
For Angel Gil, Professor of Preventive Medicine and Public Health, the cost-benefit ratio of a vaccine is “tremendously positive.” “We have seen it there are fewer cases of immune-preventable diseases if the population is vaccinated since childhood, ”he explains. And it is that the fact of having almost no case of these diseases presupposes a health benefit, a great economic saving and a relief from the pressure of the health systems: hospitalizations and, therefore, the impact on the number of deaths also decreases“, Says the expert.
Why are vaccines affordable?
“The most negative side effect of a vaccine is not giving it,” he says forcefully Amós García, Head of the Section of Epidemiology and Prevention of the Health Service of the Canary Islands. And vaccinating a person for life is not that expensive for the system.
According to a report by the General Directorate of Public Health of the Ministry of Health, the expected cost of vaccination throughout life was 726.06 euros for every healthy woman and 525.89 euros for every healthy man during 2019.Yes, the cost to the population at risk increases, as they require more vaccines. Therefore, the cost ranged between € 982.99 and € 1,815 per person.
These data show that the relatively low cost of life-long vaccination and the significant health benefits of vaccination make vaccination useful and affordable. Furthermore, this report points out that, in Spain, public health expenditure in 2017 was 68,483 million euros, which equates to € 1,472 per inhabitant. Meanwhile, the average cost of each hospitalization is 4,916 euros.
Therefore, vaccination is a low-cost preventive measure considering the burden of disease, death and indirect costs it can avoid. “Look at the one mounted by COVID-19, how much it costs and hypothesize admissions in intensive care for the system for not having a vaccine. When it arrives, it will be much cheaper to vaccinate the population at risk to continue with this situation ”, adds García.
“In general, the cost of the disease to the system is relatively much higher than the cost of vaccination,” agrees David Cantarero. “A good example is the case of future coronavirus vaccines, where social benefits could thus more than compensate for the declines in health and economic activity of the -13 percent levels we are experiencing, ”he says.
Fair access and sustainability
Despite its cost-effectiveness, the sustainability of a vaccine depends on the health authorities that include it in the vaccination program. “A very important piece of information for vaccines to be effective in the population as a whole is their vaccination coverage, that is that most of the population is vaccinated“, Emphasizes Ángel Gil.
That’s why Gil insists on getting vaccination coverage, as with the flu vaccine: “Given how effective it is, we would need coverage of 70 or 75 percent of the population.” Or in the case of measles, Gil explains that its effectiveness would be achieved at 70 or 80 percent coverage, although “luckily we’re 98 percent.”
Referring to equity in access to vaccines in our country, the professor believes it is “good enough, fair enough”. Even if it is true, remember, that the coverage against meningococcus is the one a little more “unbalanced” because, like the number of cases of meningococus B it’s low, “it’s only in a couple of autonomous communities”. However, he believes that, progressively, it will be included in all of them.
Investing in vaccines
“Not enough is invested in vaccines yet. Incomprehensibly, in recent years, many European Union countries have reduced investment in vaccines and Spain is one of those that has seen a greater decrease in immunization spending, ”Cantarero says. “On the contrary, from the point of view of prevention costs, our country is at the top of the table”.
“We hope we have all learned from this lesson from the coronavirus that I can’t skimp on research and spending on vaccines, as it is a profitable investment for both the future and the present, ”says Cantarero.
However, Ángel Gil believes that enough is invested: “We have a good vaccination schedule. It is true that some vaccines are missing, but few ”. Obviously, in his view, what it takes is to increase coverage in older people to really get that cost-effective.
Also, he states that maybe some strategies would be missing: “We have a papillomavirus vaccine in girls and it would be nice to have one included in the calendar for boys.” But, even so, “we have a complete, good, convenient and, therefore, efficient schedule,” concludes Gil.
The results of the vaccination
“Vaccination provides important social benefits for the citizen, such as increasing life expectancy, reducing the incidence of disease and preventing complications, ”says Cantarero. “On the one hand it prevents the contraction of diseases and, on the other, the intelligent vaccination of the entire population makes it can control the disease and even eliminate it, ”he adds.
“Vaccines were the only tool that managed to eradicate a health problem around the world, such as smallpox,” said Amós García. “In the early part of the 20th century we died or got sick mainly from communicable problems and now, leaving COVID-19 aside, we do it for chronic or degenerative problems derived from lifestyles “. And García says that, in this change, vaccines have been a “key tool”.
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