Vaccine-Preventable Hospitalisations from Seasonal Respiratory Diseases: What Is Their True Value?

Hospitals in England experience extremely high levels of bed occupancy in the winter. In these circumstances, vaccine-preventable hospitalisations due to seasonal respiratory infections have a high cost because of the missed opportunity to treat other patients on the waiting list. This paper estimates the number of hospitalisations that current vaccines against influenza, pneumococcal disease (PD), COVID-19, and a hypothetical Respiratory Syncytial Virus (RSV) vaccine, could prevent in the winter among older adults in England. Their costs were quantified using a conventional reference costing method and a novel opportunity costing approach considering the net monetary benefit (NMB) obtained from alternative uses of the hospital beds freed-up by vaccines. The influenza, PD and RSV vaccines could collectively prevent 72,813 bed days and save over 45 pound million in hospitalisation costs. The COVID-19 vaccine could prevent over 2 million bed days and save 1.3 pound billion. However, the value of hospital beds freed up by vaccination is likely to be 1.1-2 times larger (48-93 pound million for flu, PD and RSV; 1.4-2.8 pound billion for COVID-19) when quantified in opportunity cost terms. Considering opportunity costs is key to ensuring maximum value is obtained from preventative budgets, as reference costing may significantly underestimate the true value of vaccines.

Automated summary

Hospitals in England face high bed occupancy during winter, resulting in missed opportunities to treat patients on waiting lists. This study estimates the potential of vaccines against influenza, pneumococcal disease (PD), COVID-19, and a hypothetical Respiratory Syncytial Virus (RSV) in preventing hospitalizations among older adults in England. Using a conventional reference costing method and an opportunity costing approach, the costs and value of hospital beds freed up by vaccination were quantified. The vaccines could collectively prevent thousands of bed days and save millions to billions of pounds in hospitalization costs, with opportunity costs likely to be higher than previously estimated.