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Over the past 30 years, routine childhood vaccinations in the U.S. prevented hundreds of millions of illnesses and more than a million deaths, while saving over $500 billion in direct costs, according to CDC data.

From 1994, when the was started, through 2023, routine childhood vaccinations prevented approximately:

• 508 million lifetime cases of illness
• 32 million hospitalizations
• 1,129,000 deaths

In addition, net cost savings amounted to $540 billion in direct costs and $2.7 trillion in societal costs, reported Fangjun Zhou, PhD, of the CDC's National Center for Immunization and Respiratory Diseases, and colleagues in the .

The total number of illnesses prevented ranged from 5,000 for tetanus to about 100 million for measles and varicella. The measles vaccine alone prevented 13.2 million hospitalizations, and the diphtheria vaccine prevented nearly 753,000 deaths.

The VFC program, established in 1994 in response to a measles resurgence from 1989 to 1991, "made a substantial contribution to these reductions by purchasing about half of childhood vaccines at discounted prices," Zhou and colleagues wrote.

The program provides vaccines at no cost to children who are Medicaid-eligible, uninsured, underinsured, and American Indian or Alaska Native. In 2023, approximately 54% of children were eligible to receive vaccines through the VFC program.

Monetary investment in both VFC and non-VFC childhood vaccinations appears to be money well-spent. The societal costs of routine childhood immunization across 30 cohorts of children were about $268 billion, but led to societal savings of $2.9 trillion by preventing illnesses and deaths, Zhou and colleagues noted.

"This calculation means that every $1 spent on childhood immunizations results in a savings of approximately $11. With discounted vaccine prices, every $1 spent on the VFC program results in even further savings," they posited.

Routine childhood vaccination coverage declined during the COVID-19 pandemic, Zhou and team pointed out, due to decreased access to primary care, spread of vaccine-related misinformation, and increases in vaccine hesitancy. A recent and dramatic rise in measles cases in the U.S. and other countries serves as a reminder that "high vaccination coverage is critical," the authors emphasized.

The analysis looked at all routine childhood vaccinations including the diphtheria/tetanus/acellular pertussis (TDAP) vaccine; the Haemophilus influenzae type b conjugate vaccine; poliovirus vaccines; the measles, mumps, and rubella vaccine; hepatitis A and B vaccines; the varicella vaccine; the pneumococcal conjugate vaccine; and the rotavirus vaccine.

COVID-19 and influenza vaccinations were not included in the analysis because methods for assessing their costs and effects differ from other vaccines, the study authors said. The maternal RSV vaccine (Abrysvo) and immunization with nirsevimab (Beyfortus) to protect infants and children from RSV were also not assessed, due to their recent approval and rollout.

Direct costs included direct medical costs, such as those associated with treating acute infections, as well as lifetime costs to manage complications and other sequelae. Direct nonmedical costs included travel and costs associated with disabilities as a result of vaccine-preventable diseases. Societal costs included both direct and indirect costs. Indirect costs were those associated with loss of productivity due to disability and premature death, as well as costs to parents and caregivers, including missed work.

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