Economics of adult immunization

[PHP Nepal Vol 1 Issue 10 Oct-Nov 2011] | The practice of adult immunization is less widespread in all the societies though it has been constantly reiterated that it is a safe, effective, and simple way to prevent life threatening illness in adults.  Immunizations among adults, in many cases, are found to be more than 50 % effective.  Many studies have shown that immunization has the potential to significantly boost economic growth. It prevents millions of deaths every year and reduces the costs of treatment and disability caused by infectious diseases. The economic burden of a disease measures both direct cost and indirect cost associated with the disease.

The economic burden in Nepal might go much higher when indirect costs are also taken into consideration as it measures the full economic costs imposed upon nation by illness, disability, and premature death. These include the loss of output to the economy. The authorities in Nepal only takes into account the direct costs such as diagnostic cost, service cost, medical cost, and cost of travel to compute the health cost to patients.

Hepatitis can be taken as a case in point which attacks people in their most productive years and has already killed more people in the Southeast Asia region than malaria, dengue, and HIV/AIDs combined.(WHO, SEAR/1525) Moreover, during the first World Hepatitis Day in July, this year, WHO warned–“viral hepatitis might result in the death of more than five million people in the Southeast Asia region in the next 10 years if the awareness level against the disease remains low and measures are not taken to combat the disease.” This implies that the economic burden from the disease is likely to increase significantly in the recent future from such preventable deaths in the region. Whatsoever, to prevent this infectious disease, the government of Nepal has taken a major step forward by introducing Hepatitis B vaccine in its National Immunization Program in the year 2004. However, this vaccine is made available only to the children below 1 years of age leaving behind a large number of population including adolescents and adults unvaccinated against Hepatitis disease. This implies that the economic growth of the country will be seriously under reported as more people of productive age will die of Hepatitis B.

Studies have shown some important reasons for under utilization of vaccines in adults. These are:

• Low prioritization of the importance of vaccines preventable diseases among adults;

• Uncertainty or lack of knowledge about the safety and efficacy;

• Lack of universal recommendations for all adults; and

• Financial constraints, especially in developing countries.

Consequently, there is an urgent need for coordinated global action to tackle the problem of adult immunization. The global statistics are overwhelming and they even underestimate the true disease burden. The governments are aware of the statistics and yet there has been very little eagerness for action despite the compelling evidence; an international mandate is now essential.

Nirmal Kumar Raut is a lecturer in Health Economics at Tribhuvan University, Kathmandu, Nepal.

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