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

Since 1994, when the Vaccines for Children (VFC) program was launched, through 2023, routine childhood vaccinations have prevented approximately the following cases:

• 508 million cases of illness over the course of a lifetime
• 32 million hospital stays
• 1,129,000 dead

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 Weekly report on morbidity and mortality.

The total number of cases prevented ranged from 5,000 for tetanus to around 100 million for measles and chickenpox. The measles vaccine alone prevented 13.2 million hospitalizations, and the diphtheria vaccine prevented almost 753,000 deaths.

The VFC program, launched in 1994 in response to a renewed increase in measles cases between 1989 and 1991, “made a significant contribution to this reduction by purchasing about half of all childhood vaccines at discounted prices,” write Zhou and his colleagues.

The program provides free vaccines to children who are eligible for Medicaid, are uninsured or underinsured, and are American Indian or Alaska Native. In 2023, about 54% of children were eligible to receive vaccines through the VFC program.

Investing in VFC and non-VFC childhood vaccinations appears to be money well spent. The societal cost of routine childhood vaccinations in 30 cohorts of children was about $268 billion, but resulted in societal savings of $2.9 trillion from preventing disease and death, Zhou and colleagues found.

“This calculation means that every dollar spent on childhood vaccinations results in savings of about $11. With discounted vaccine prices, every dollar spent on the VFC program results in even greater savings,” they noted.

During the COVID-19 pandemic, routine vaccination rates among children have declined, Zhou and his team stressed. This is due to poorer access to primary care, the spread of misinformation about vaccines, and increasing vaccine hesitancy. A recent and dramatic increase in measles cases in the United States and other countries is a reminder that “high vaccination rates are critical,” the authors stressed.

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

COVID-19 and flu vaccines were not included in the analysis because the methods used to assess their costs and impacts differ from those of 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 evaluated because of their more recent approval and introduction.

Direct costs include direct medical costs, such as treatment of acute infections, and lifetime costs for treating complications and other sequelae. Direct non-medical costs include travel costs and costs related to disability resulting from vaccine-preventable diseases. Societal costs include both direct and indirect costs. Indirect costs are those associated with productivity losses due to disability and premature death, and costs to parents and caregivers, including missed work.