Economic evaluation of vaccine programmes in paediatric populations

In the widespread context of limited resources to fund health care interventions available to a population, explicit criteria are required to select the health care package that achieves the maximum population health with existing resources. Economic evaluation of health interventions is an analytical tool that compares the costs and health benefits of alternative health programmes with the aim to inform about their efficiency. The traditional economic evaluation framework has some limitations for the specific evaluation of public health programmes such as vaccine programmes, especially for those targeted to the paediatric population. Among these, we highlight the challenges of evaluating interventions with long-term health effects on different populations to which the intervention is applied, with possible adverse events on healthy individuals, with considerable intangible effects, with relevant implications on inequalities, and that require the quantification of health effects on children as well as their relatives. The main lines of further developments for economic evaluation to address the inherent issues of vaccine programmes for children that we highlight consist in the possibility of using outcomes measures capable of capturing social well-being benefits beyond individual health improvements, as well as the application of methods to characterise dynamic effects and high levels of uncertainty when these are needed.