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Table 1 Categorized list of the economic impact of vaccination

From: Stakeholders’ perception on including broader economic impact of vaccines in economic evaluations in low and middle income countries: a mixed methods study

Category Definition
A. Burden of disease
 1. Morbidity Cases averted [14]
 2. Mortality Deaths averted [14]
 3.Quality of life measures DALYs and QALYs [14,16]
 4. Health care cost savings Reduction in cost of health care borne by the public sector or private individuals [16,23]
 5. Governmental savings Reduction in overall costs of government expenses. [21]
B. Productivity-related gains [14,22]
 1. Care-related productivity gains Reduction in lost days of work due to sickness or caring for a sick patient
 2. Outcome-related productivity gains Increased lifetime productivity due to better health improves cognition, educational attainment and physical strength
 3. Behavior-related productivity gains Economic improvements due to changes in household choices such as fertility and consumption/saving as a result of improved child health and survival
C. Ecological effects
 1. Prevalence of drug resistance Vaccination can prevent disease and thus obviate the need for antibiotic use, reducing the prevalence of antibiotic-resistant strains [14,22]
 2. Serotype replacement effects After the introduction of vaccine, non-vaccine serotypes may well replace vaccine serotypes, leading to a smaller reduction in disease burden over time [24].
 3. Herd effect Benefits accruing because vaccination improves outcomes among unvaccinated community members [21]
D. Indirect effects
 1.Equity More equal distribution of health outcomes [4,19].
 2. Interaction with other interventions Events happening during the evaluation period not related to the intervention [4,25].
 3. Health resources Impact of vaccine programs on amount of health resources available (time, availability) [25]
 4. Priority of interventions Overlooking importance of social determinants of health by focusing on ‘silver bullets’ and ‘mass campaigns’ instead of adapting interventions to the prevailing culture and socioeconomic conditions, which generate the felt needs. [23]
E. Macro-economic impact
 1. Burden on other sectors Macro-economic effect of vaccines on other sectors during epidemics [26]
 2. School absenteeism Amount of schooldays missed due to illness [16,27,28].