Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to strengthen the evidence base for assessing the wider economic and societal impacts of vaccination; and what assessment they have made of the potential benefits for evidence generation of explicitly incorporating such impacts into health technology assessment frameworks.

The Government recognises the value in improving our understanding of the impact that vaccines have on wider society. Demonstrating the impact that childhood vaccines can have on the number of days of education that children may miss, for example, could encourage greater uptake of childhood vaccination. We have recently been able to say that childhood chickenpox costs the United Kingdom’s economy £24 million every year in lost income and productivity, and the chickenpox vaccination programme launched last month is expected to reduce that loss.

Vaccine appraisals play a particular role within the process of understanding that value, using the best robust evidence available across all vaccination programmes to focus investment of the health budget on programmes that deliver the greatest health benefit to the greatest number of people. Focusing our appraisal process on health benefits and costs, which have better evidence than socio-economic impacts, follows the process used by the National Institute for Health and Care Excellence.

If this process were to change, and wider socio-economic benefits were to be formally included, this could have unintended consequences. For example, it could have the effect of prioritising investment in vaccines for working populations over those who are not or will not be economically active. Additionally, the available data on socio-economic benefits is robust for only a small number of vaccines. Factoring this data into appraisals for only a small number of vaccines would create a bias for these programmes with better quality data. Conversely, if this data on wider benefits were to be factored into appraisals for all vaccination programmes, the use of lower quality data risks increasing uncertainty in appraisals and reduces our ability to ensure responsible and effective spending of public funds.