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Return On Investment From Immunization Against 10 Pathogens In 94 Low- And Middle-Income Countries, 2011–30


Estimating the value of global investment in immunization programs is critical to helping decision makers plan and mobilize immunization programs and allocate resources required to realize their full benefits. We estimated economic benefits using cost-of-illness and value-of-a-statistical-life approaches and combined this estimation with immunization program costs to derive the return on investment from immunization programs against ten pathogens for ninety-four low- and middle-income countries for the period 2011–30. Using the cost-of-illness approach, return on investment for one dollar invested in immunization against our ten pathogens was 26.1 for the ninety-four countries from 2011 to 2020 and 19.8 from 2021 to 2030. Using the value-of-a-statistical-life approach, return on investment was 51.0 from 2011 to 2020 and 52.2 from 2021 to 2030. The results demonstrate continued high return on investment from immunization programs. The return-on-investment estimates from this study will inform country policy makers and decision makers in funding agencies and will contribute to efforts to mobilize resources for immunization. Realization of the full benefits of immunization will depend on sustained investment in and commitment to immunization programs.



Total immunization program costs for ten pathogens increase from $25.2 billion in the first decade (2011–20) to $39.9 billion in the second decade (2021–30) for ninety-four low- and middle-income countries (exhibit 1). The total costs approximately average out to $24.6 per surviving infant in the first decade and $41.2 per surviving infant in the second decade (data not shown), which is within the range estimated by empirical studies.44 For Gavi countries, the costs increase from $21.7 billion between 2011 and 2020 to $36.2 billion between 2021 and 2030 (exhibit 1). Exhibit 2 shows the overall increasing trend for total costs.

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