The socioeconomic value of adult respiratory vaccination in Australia: a benefit-cost analysis

Background Pneumococcal disease, respiratory syncytial virus, influenza and COVID-19 cause a major burden of illness and death among adults, much of which is vaccine-preventable. We estimated the societal value of adult vaccination against these four pathogens in Australia.Research design and methods We developed disease-specific static life table cohort models and conducted a societal-perspective benefit-cost analysis of adult respiratory vaccination, approximating those recommended by the Australian Technical Advisory Group on Immunization, relative to no vaccination. Mortality risk reductions were monetized using value of a statistical life (VSL) and value of a statistical life year (VSLY); avoided morbidity and productivity losses were also captured. Main outcomes were benefit-cost ratios (BCRs) and net monetary benefits (NMBs).Results Over ten years, age and risk-based vaccination generated gross returns of $11.24 (VSL) and $5.69 (VSLY) per Australian dollar invested (net returns $10.24 and $4.69), with NMBs of $64.97 billion and $29.76 billion, averting 234,187 hospitalizations and 13,890 deaths. BCRs remained well above 1 across all scenarios.Conclusions Adult respiratory vaccination shows strong societal returns. Improving coverage and extending eligibility offer the potential for further societal gains. Some simplifications in the model are likely to understate the value of vaccination while others may overstate it.