Public health benefits of vaccines

Vaccination has saved more lives and prevented more serious diseases than any advance in recent medical history.

Video transcript

Why is immunisation important for public health?

Immunisation or vaccination is important for public health because it's a preventive tool so you're not getting sick in the first place I think that's the first thing.

The second thing is that it can be applied to all ages. You can have vaccines for infants adolescents, or the older adults.

Maybe the third point is when you get vaccinated, you are protected, but if enough people in the community get vaccinated, it stops the spread of the disease. So these are two really important elements in terms of public health.

What is the best way of ensuring that people who need vaccinations have access to them?

I think first, people have to know about vaccines and vaccination.

Everyone knows that small children have to be vaccinated, but I think it's less known that there are recommendations to vaccinate, pregnant women, or adolescents or new vaccines for older adults so it's important that people actually know.

The second thing is in terms of access.

Every county organises vaccination differently so there are different distribution channels, different reimbursement schemes, and people have to know how to make access to vaccines, I think this is important.

What excites you the most about vaccination in the future?

What really excites me is that the technology has really advanced, so we have new tools to develop new vaccines and that is true for the industry, but also for people in academia.

So there are great efforts to develop new vaccines for pregnant women, for babies; there's some infectious diseases out there which we would like to protect with vaccines, but as the population ages, vaccines for older adults becomes more and more important.

So vaccines at all ages is essentially what excites me.

Every year, 2 – 3 million lives are saved across the world because of immunisation and only clean water rivals vaccines at reducing infectious diseases and deaths. ^1,2

Dr Thomas Breuer is Chief Medical Officer of GSK Vaccines and spoke to us about the value of immunisation and vaccination.

1. The economic impact of vaccination is broad

By promoting good health in children, vaccines help to increase cognitive skills, physical strength and performance at school.2

Increasing investments in vaccination can potentially help keep people healthy and empower them to be independent contributors to society and active for longer.3 Vaccination helps to prevent productivity loss through illness and absence from work.4 6 million working days are lost in the UK due to seasonal influenza every year.5

Vaccines help reduce the risk of catching infectious diseases while travelling, making it safer for people to travel for work or leisure.6

2. Global investment in vaccines has a giant impact

Decisions about whether to implement a new immunisation programme are usually based on the health benefits of vaccination but when broader societal benefits such as education or productivity are considered, vaccination is even more cost-effective.[7]

For every dollar invested in vaccination in the world’s 94 lowest-income countries, US$16 are expected to be saved in healthcare costs, lost wages and lost productivity due to illness and death.

If we include broader benefits, such as the value that people place on living healthier, longer lives and the long-term burden of disability, the net return increases to US$ 44 per dollar invested.[8]

The cost-effectiveness of immunisation has made vaccines increasingly affordable for low-income countries. While all low-income countries are largely dependent on external support to finance vaccination, domestic investment in immunisation is rising.[8]

Pharmaceutical companies based in industrialised countries like the UK help provide an adequate supply of suitable vaccines through Gavi, The Vaccine Alliance to people living in the world’s poorest countries. Our members are:

Making vaccines available at low prices and participating in innovative financing mechanisms, such as the Advance Market Commitment (AMC), which provides a platform for investing in the development of a sustainable supply of breakthrough vaccines.
Helping develop technologies that facilitate the distribution of vaccines and the way they are administered.
Contributing to the education of public health officials and working to engage other private sector organisations in Gavi’s mission.[9]

The UK Government was one of the six original donors to Gavi and continues to be a major supporter. For the period 2016-20 the UK contributed £1.44 billion to Gavi, making up almost one quarter of the total funds.[10]

1948

Number of NHS vaccinations against infectious diseases

2018

Number of vaccinations against infectious diseases offered routinely or to people most at risk

3. Pharmaceutical companies need to make rigorous decision about what they research

Developing vaccines takes deep scientific knowledge and expertise. Pharmaceutical companies need to make decisions about what research they’re going to invest in and generally look at four questions

What value will it provided patients? They need to make sure the new vaccine establishes a new standard of care which has the potential to significantly extend and improve patient lives.

What value will be provided to health care systems? They aim to reduce the costs associated with hospitalisation and other costly complications of disease if not appropriately (or optimally) treated.

What is the unmet need? They need to make sure any new vaccine addresses a critically unmet medical need, where few or no treatments exists.

What is the R&D sustainability? What will continued investment in risky and capital-intensive R&D come up with, and is this a sufficiently important breakthrough?

4. Pharmaceutical companies are working in collaboration to develop new vaccines

Antimicrobial resistance

Vaccines can have a vital role in the fight against antimicrobial resistance. If you can stop people from catching infections, you can reduce the number of antibiotics being used. And the less antibiotics are used, the lower the chance of resistance developing.

When enough people are vaccinated, it’s possible to stop the spread of infection – so-called ‘herd immunity’.

Making the most of the vaccines we have and ensuring as many people as possible are vaccinated is vital.

The Hib vaccine has virtually eliminated infection caused by resistant influenzae type b.¹²
Diphtheria and pertussis do not appear on lists of resistant diseases of public health concern because they are almost entirely preventable by vaccination.¹³
Universal coverage of pneumococcal vaccination could avoid 11.4 million days of antibiotic use per year in children under five.¹²
Antibiotic use for respiratory illnesses has been shown to fall by 64% after influenza vaccination is introduced.¹⁴

Pharmaceutical companies are constantly researching new vaccines to protect against other infections.

The UK Government has an opportunity to make sure vaccines are deployed effectively as part of their prevention strategy.

Reducing demand on the NHS

Flu vaccination is one of the most effective interventions to keep people well and reduce pressure on health and social care services during winter. Immunising older people reduces the incidence of severe disease including bronchopneumonia, hospital admissions and mortality.¹⁵

Before the introduction of a vaccination programme, Rotavirus infection in the under 5s was responsible for around 140,000 young children visiting the GP and 14,000 babies and young children being admitted to hospital every year, as well as 37,000 NHS Direct calls and 30,000 A&E attendances.³

Vaccination has led to a 69% fall in the number of cases of rotavirus.³

Keeping people healthy at all stages of life

With the proportion of people aged 60 years and older growing faster than any other population worldwide, vaccination has become a key component of healthy ageing and can slow down physical decline.^16,17

The NHS vaccinates older people against seasonal influenza, pneumococcal disease and shingles.¹⁰

Protecting people with existing health conditions

Vaccination helps people with serious and long-term conditions to stay well and avoid the need for medical care.¹⁸

The NHS offers some vaccines to groups of people who need extra protection from particular infectious diseases because they have underlying health conditions such as chronic heart, respiratory or neurological conditions, problems with the spleen or a weakened immune system.¹⁹

References and further links

Stat - specific references

1948 – Number of NHS vaccinations against infectious diseases = 2⁹
2018 – Number of vaccinations against infectious diseases offered routinely or to people most at risk = 20^10,11

Page references

¹ Global Immunisation Factsheet (WHO, Jan 2018)

² Andre FE et al. Vaccination greatly reduces disease, disability death and inequity worldwide. Bulletin of World Health Organisation 2008;86:81-160.

³ Why vaccinate (PHE, Apr 2018)

⁴ UK measles and rubella elimination strategy 2019 (PHE, 2019)

⁵ Parikh et al. Effectiveness and impact of a reduced infant schedule of 4CmenB vaccine against group B meningococcal disease in England: a national cohort study, Lancet online, 27 October 2016

⁶ Amirthalingam, G., et al. Evaluation of the effect of the herpes zoster vaccination programme 3 years after its introduction in England: a population-based study. Lancet Public Health.  2017 Dec 21. pii: S2468-2667(17)30234-7. doi: 10.1016/S2468- 2667(17)30234-7. ^{Epub ahead of print}

⁷ Ladhani Sn et al. Rapid increase in non-vaccine serotypes causing invasive pneumococcal disease in England and Wales, 2000-17: a prospective national observational cohort study. Lancet Infect Dis. 2018 Apr;18(4):441-451.

⁸ Palmer T et. Al. Prevalence of cervical disease at age 20 after immunisation with bivalent HPV vaccine at age 12-13 in Scotland: retrospective population study. BMJ 2019;365:I1161. Available at https://doi.org/10.1136/bmj.I1161. Last accessed April 2019

⁹ Department of Health: Chief Medical Officer’s Annual Report 2007, Chapter 5 (DH, Jun 2018)

¹⁰ Routine Immunisation Schedule January 2020 (PHE, Apr 2020)

¹¹ Chicken pox (NHS, 2020) and Travel vaccines (NHS, 2020)

¹² Parliamentary Office of Science and Technology. POSTNote 581, July 2018

¹³ Vaccines and alternative approaches: reducing our dependence on antimicrobials (Review on AMR, Fb 2016)

¹⁴ Atkins and Lipsitch. Can antibiotic resistance be reduced by vaccinating against respiratory disease? Published:July 31, 2018

¹⁵ National flu programme training slide set for 2019-20 (PHE, 2019)

¹⁶ Preventing care and health aging (Economist Intelligence Unit, 2012)

¹⁷ IFA Global Conference on Aging (International federation of Aging, 2020)

¹⁸ Nichol KL et al. Influenza vaccination and reduction in hospitalizations for cardiac disease and stroke among the elderly. N Engl J Med 2003;348:1322-1332

¹⁹ NHS vaccinations and when to have them (NHS, Apr 2020)