Table 2.

Type of benefits in economic evaluations of vaccinations: application to Hib vaccination

Perspective	Benefit categories	Definition	Hib-specific examples
Narrow	Health gains	Reduction in mortality through vaccination	Hundreds of thousands of children die each year from Hib disease
	Healthcare cost savings	Medical expenditure savings because vaccination prevents disease episodes	Hib disease leads to substantial healthcare costs
	Care-related productivity gains	Savings of parents’ productive time because vaccination avoids the need for missing work to take care of a sick child	Parental care of children suffering from Hib disease can contribute substantially to the overall cost of the disease
Broad	Outcome-related productivity gains	Increased productivity because vaccination improves cognition and physical strength, as well as school enrolment, attendance, and attainment	Hib meningitis is relatively common and leaves 15–35% of survivors with permanent disabilities, such as mental retardation or deafness, which can severely reduce cognition
	Behaviour-related productivity gains	Benefits accrue because vaccination improves child health and survival, and thereby changes household choices, such as fertility and consumption choices	Hundreds of thousands of children die each year from Hib disease
	Community externalities	Benefits accrue because vaccination improves outcomes among unvaccinated community members	Hib infections are treated with antibiotics, leading to the development of resistance. Hib vaccination can protect unvaccinated individuals through herd effects

From Ref. (12).