The broader socio-economic value of adult respiratory disease vaccinations in the UK - results from a benefit cost analysis.

Abstract

Background: Respiratory infections such as pneumococcal disease (PD), RSV, influenza (flu), and COVID-19 impose a major socio-economic burden in the UK. Adult vaccination programs cost-effectively reduce this burden, yet their societal value remains under-assessed.

Methods: A benefit-cost analysis (BCA) using life-table-based disease modeling estimated morbidity and mortality reductions from current age- and risk-based recommendations. Mortality risk reduction was monetized using two approaches: value of a statistical life year (VSLY) and hence adjusting for remaining life expectancy, and value of a statistical life (VSL), assuming equal valuation across ages. Scenarios included current and expanded eligibility. Outcomes were reported as benefit-cost ratios (BCRs) and net benefits (NBs).

Results: Over each cohort's lifetime, vaccinations prevented 313,000 hospitalizations, freed up 1.9 million bed days, and averted over 86,000 deaths. First-year BCRs were 5.1 (VSLY) and 19.3 (VSL), with NBs of £5.1 billion and £23 billion, respectively. Lifetime net benefits ranged from £35.5 billion to £200.1 billion, with BCRs of 5.8 and 27.8. Expanded eligibility further increased NBs but lowered the BCR.

Conclusion: Adult respiratory vaccination delivers socio-economic benefits well beyond direct health-care savings, yet investment remains low. Considering broader impacts beyond standard cost-effectiveness can better align policy with public health and economic goals.