BACKGROUND: Greece has one of the most extensive pediatric vaccination programs in Europe preventing against 14 pathogens. The aim of the study was to assess the public health and economic impact of the pediatric immunization program (PIP) in Greece.
METHOD: An Excel-based model was developed to determine the impact of 9 vaccines, covering 14 pathogens, included in the Greece PIP recommended for children aged 0-11 years. Separate decision trees were used to model the 14 pathogens: diphtheria, tetanus, pertussis, poliomyelitis, Haemophilus influenzae type b, measles, mumps, rubella, Streptococcus pneumoniae, rotavirus, meningococcal types A-C-W-Y, varicella, hepatitis A, and hepatitis B. The 2022 birth cohort (82,700 children) was followed over the lifetime. The model compared health outcomes and costs in scenarios with and without the PIP, based on Greece-specific current vs. pre-vaccine era disease incidence estimates, respectively. The model estimated discounted incremental disease cases, deaths averted, life-years lost, quality-adjusted life-years lost, costs, and an overall benefit–cost ratio (BCR). For the societal perspective, the model also included productivity loss costs associated with disease.
RESULTS: PIP is estimated to prevent 274,000 cases of disease, 208 deaths, and loss 5,680 life-years and 8,880 quality-adjusted life years over the lifetime of the birth cohort. Compared to no PIP, the PIP was associated with savings of €32 million and €195 million from the payer and societal perspectives, respectively. For every €1 invested in childhood immunization resulted in €3.11 in cost savings from a societal perspective for Greek PIP. When economic value of QALYs gained was included in the BCR calculation, the societal BCR substantially increased (BCR = 8.35).
CONCLUSIONS/LEARNING POINTS: The Greek PIP provides extensive public health benefits and is cost-saving, as it substantially averts disease-related morbidity and mortality from vaccine-preventable diseases.
