El Banhawi Hania, Bell Eleanor, Neri Margherita, Brassel Simon, Chowdhury Sulayman, Steuten Lotte
Office of Health Economics, London SE1 2HD, UK.
Vaccines (Basel). 2024 Jul 29;12(8):852. doi: 10.3390/vaccines12080852.
Vaccine-preventable diseases continue to generate a substantial burden on health, healthcare systems, and societies, which is projected to increase with population ageing. There is a need to better understand the full value of adult immunisation programmes corresponding to the broader value of vaccine frameworks that are recommended for evidence-based decision-making. This review aims to summarise and map evidence for the value of selected adult immunisation programmes (seasonal influenza, pneumococcal disease, RSV, and HZ) in ten diverse countries. We conducted a structured literature review of evidence published from 2017 to 2023. An existing framework was used to structure the assessment, developing matrices demonstrating the elements of value evidenced for each vaccine and country of focus. Our analysis showed substantial evidence base on the value of adult immunisation programmes, but the availability of evidence varied by value element and by vaccine. The impact on the quality of life of the vaccinated individual was the most evidenced value element. Mortality benefits for vaccinated individuals and cost-offsets to healthcare systems were also well-evidenced. The availability of evidence for 'broader' societal value elements (such as transmission value, carer productivity and impact on social equity, and antimicrobial resistance prevention) varied. No evidence was identified relating to the broader value elements of macroeconomic effects, value to other interventions, or effects on the quality of life of caregivers. Robust evidence exists to show that adult immunisation programmes generate substantial value for population health and health systems, yet some elements of broader value remain underrepresented in the academic literature. Without such evidence, the full value of immunisation programmes is underestimated, risking suboptimal policy decisions.
疫苗可预防疾病继续给健康、医疗保健系统和社会带来沉重负担，预计随着人口老龄化，这一负担还会增加。有必要更好地理解成人免疫规划的全部价值，这与为循证决策而推荐的疫苗框架的更广泛价值相对应。本综述旨在总结和梳理十个不同国家中选定的成人免疫规划（季节性流感、肺炎球菌疾病、呼吸道合胞病毒和带状疱疹）的价值证据。我们对2017年至2023年发表的证据进行了结构化文献综述。使用现有的框架来构建评估，制定矩阵展示每种疫苗和重点国家所证明的价值要素。我们的分析表明，有大量证据支持成人免疫规划的价值，但证据的可获得性因价值要素和疫苗而异。对接种者生活质量的影响是最有证据支持的价值要素。接种者的死亡率益处以及对医疗保健系统的成本抵消也有充分证据。“更广泛”的社会价值要素（如传播价值、照顾者生产力和对社会公平的影响以及抗菌药物耐药性预防）的证据可获得性各不相同。未发现与宏观经济影响、对其他干预措施的价值或对照顾者生活质量的影响等更广泛价值要素相关的证据。有力的证据表明，成人免疫规划为人群健康和卫生系统带来了巨大价值，但学术文献中一些更广泛价值要素的体现仍然不足。没有这些证据，免疫规划的全部价值就会被低估，从而有导致政策决策不够优化的风险。
