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Additionally, the committee assumed that utilization of vaccines would be through the WHO-EPI and at a uniform rate. Hence, the cost of delivery and administration would not be a factor in differentiating among vaccines.

These judgments lead to simplification of the cost components of this analysis: the cost of vaccine development and the cost of vaccine for immunization programs (see Figure 1.2). These “expenditures on vaccine” can, if desired, be included as a criterion in the decision process, representing the composite “affordability” of disease control efforts.

However, these estimated expenditures are only relative, not absolute, because they exclude elements assumed to be uniform, that is, administration and utilization. Further, the omission of cost savings, which may vary between diseases, means that the estimates do not indicate the net cost of the total effort to control a given disease by immunization. Net costs may in fact be negative; that is, a vaccine can be cost saving.

FIGURE 1.1 Calculation of potential health benefits.



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