Vaccination programme cuts diseases and costs
Publication date
20.3.2014
13.27
Type:News item
N5-64173
Puumalainen hopes that, despite the pressure to make savings, the state will see the vaccination programme more as an investment than an expense. He points out that vaccinations improve well-being and are proven to be cost-effective and in terms of their impact the best preventive health care.
“The serious medical conditions caused by rotavirus and pneumococcal infections have largely disappeared. Before, hospital wards had many cases of diarrhoea in babies born in early spring, but no longer. The same applies to pneumonia. Paediatricians have been very impressed by the effectiveness of the vaccines.”
Good cost-savings ratioIn 2008, the national vaccination programme covered nine vaccines, which accounted for annual public expenditure savings of an estimated €30 – 100 million. The wide differential in the figures is because many vaccinations were initiated decades ago. It is difficult to estimate what the disease burden would be without vaccinations, or what the significance of developments in health care would have been in terms of treatment outcomes.
It is easier to calculate the cost savings afforded by new vaccines. Recollections of morbidity and its resulting effects are still relatively fresh, and there has not been sufficient time for major changes in treatment to happen.
“From 2010-12 rotavirus and pneumococcal vaccinations accrued savings of more than €30 million on €16.6 million in expenditure. Public finances therefore benefitted by €14 million over a three year period. The rollout of HPV vaccinations for girls last year is expected to bring savings of €4 million a year,” says Puumalainen.
Savings come from the reduction of health care costs and the increase in work productivity. Loss of productivity due to disease can vary widely.
“For example the burden of gastroenteritis that the rotavirus causes is highest among children under one-year old. With children of this age, one of the parents is usually still at home, and so absences from work are low. But with chickenpox, morbidity is usually over the age of two, in which case parental productivity costs are heavy. A minimum of five days quarantine at home means for a parent a week’s absence from work.”
Inclusion of new vaccines?In Finland new vaccines can be introduced to the national vaccination programme if they meet four key criteria: a high public health disease burden that is to be prevented, the vaccine must significantly reduce the disease burden, it should not have any significant adverse events on individual or population level, and the intervention should be reasonably cost-effective to justify the expense from the state budget.
The vaccination programme currently includes 12 vaccinations, but Puumalainen hopes that vaccination against chickenpox will be added to the list.
“98% of children get chickenpox, which vaccination could prevent almost totally. Though the consequences of the disease are rarely severe, they can affect large numbers of people. For example, encephalitis is caused by chickenpox far more often than by tick-borne infection.”
Vaccinating children against chickenpox would cost the state some €4.2 million and save €14 million. It would also help reduce inequalities in health. At present, about 10% of children are vaccinated against the disease. Parents bear the costs of this, and so vaccinations largely benefit wealthier families.
While introducing a new vaccine into the vaccination programme increases immediate costs, the savings made due to the resulting decrease in disease accrue rapidly. Some of the benefits of vaccination may be more long term. The benefit of the HPV vaccination of girls is evident only when there are cellular changes in the cervix following papillomavirus infection. Other benefits may be indirect.
“The treatment of pneumococcal diseases requires many antibiotics, the abundant use of which has its own problems. The pneumococcal vaccine reduces the need for antibiotics and the appearance of drug-resistant bacteria,” Puumalainen explains.
Smallpox was successfully eradicated globally, and the population is no longer vaccinated against it. The year 2018 has been set as the target date for the eradication of polio through vaccinations. Puumalainen believes that measles and rubella could also be eradicated by a much later date. However, not all vaccinations will become wholly obsolete.
“Infectious diseases passed from person-to-person could be made to disappear. But if human beings are not the only source of infection, the situation is different. The tetanus bacterium, often found in soil, cannot be eradicated, so it will always be necessary to vaccinate against it.”
Text: Paula Mannonen and Mark Waller
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