Review reveals lack of economic analysis of vaccine uptake interventions

A systematic review of vaccine uptake intervention studies has shown a lack of economic analysis to support decision making. The review, led by ARC West researchers and published in Vaccine, looked at 37 randomised controlled trials, the gold standard of research study.

Interventions fell into 4 broad categories, with some using more than one:

• Access – improving access, for example by making vaccinations available at different times and places
• Education – increasing awareness and understanding of vaccines
• Reminder – making sure people don’t miss their vaccination appointment
• Affordability – more relevant in countries without a publicly funded health service, these interventions could include cash incentives or offering free vaccinations

The team found a lack of detailed information about the costs of programmes designed to increase vaccine uptake. Many studies only looked at basic costs, like staff time or materials, and didn’t include all the possible expenses. Also, the quality of the economic evaluations was generally poor.

Dr Yuri Hamashima, Senior Research Associate in Health Economics at ARC West and lead author of the study said:

“The lack of good cost data makes it hard for decision-makers to choose which interventions to fund, especially when budgets are tight. This is important because all the types of interventions we looked at were shown to be effective. So we need better information to decide which ones give the best value for money.”

The team highlighted a particular need for more cost data for interventions that:

• Make it easier for people to get vaccinated (access)
• Help people afford vaccination (affordability)
• Combine multiple strategies (for example, education plus reminders)

The researchers call for future studies to clearly report costs for different groups of people and settings. This will help ensure fair decisions and take into account the needs of different communities.

This project is funded by the National Institute for Health and Care Research (NIHR) Public Health Research Programme (Grant Reference Number NIHR135130), and the principle investigator is Dr Clare French (NIHR Health Protection Research Unit in Evaluation and Behavioural Science, University of Bristol).