As low- and middle-income countries expand domestic investment in vaccines, data on the economic value of these investments can help decision-makers compare the benefits of vaccination with other health and non-health investments. These data can also provide advocates with rigorous evidence to demonstrate the impact of vaccines in terms that are comparable with other sectors. Additionally, it is crucial to understand inequities in access and coverage and how inequitable vaccine coverage may impede full realization of the benefits of vaccines at the national level.
Our goals are to:
Create the Vaccine Equity-Efficiency Model, a standardized model for assessing, tracking, and targeting vaccine coverage inequity at the country level and for monetizing the economic losses due to inequity. The model will also enable the assessment of equity and efficiency tradeoffs in immunization coverage.
Generate country-specific benefit assessments: adapt the Decade of Vaccine Economic (DOVE) models used by international organizations to compute the economic benefits and return-on-investment of vaccines to be usable at the country-level by decision-makers.
Estimate the economic burden of illness by filling gaps in cost-of-illness and economic benefits data at the country level for use in country-specific models through collaboration with stakeholders in Bangladesh, India, Nigeria, and Uganda.
Assess financing gaps and develop sustainable financing plans to meet future vaccine coverage targets by applying new data to a costing, financing, and funding gap model.
Develop high-level and country-specific education materials to support decision-makers and advocates on collecting and using vaccine economic data as evidence in decision-making and advocacy.
The VERSE Equity Toolkit was officially launched on 25th May 2022. Watch the recording here. Many resources were offered to attendees, which you can access here.
The VERSE Equity Toolkit to analyze publicly available DHS data is available in open access in the repository here.
We published a friendly introduction to using the toolkit and User Guide for your convenience.
A recording is now available from an October webinar co-hosted by Makerere University College of Health Sciences and IVAC on equity analysis in healthcare, focused on insights and best practices for analyzing and advancing health equity measurement using the VERSE Equity Toolkit.
Bangladesh
Co-led with the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), the VERSE project estimates the economic burden of vaccine-preventable diseases and examine the inequity in immunization coverage in diverse urban (slum and non-slum) and rural settings.
China
In partnership with Peking University, the VERSE project examines geographic, sociodemographic, and socioeconomic inequalities in vaccine coverage for vaccines covered by China’s National Immunization Program (NIP) and non-NIP vaccines. It will be tailored to help regional and national policymakers make a stronger case for investment in vulnerable communities.
Ecuador
In partnership with Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador, the VERSE project estimates the return on investment (ROI) for the 10-valent pneumococcal conjugate vaccine (PCV10) by adapting the DOVE multi-country ROI model for a country level analyses. The results estimates are calculated from 2010-2030 at both national and regional levels, based on Ecuadorian information.
India
In partnership with the Postgraduate Institute of Medical Education & Research (PGIMER) of Chandigarh (India), we are using NFHS data to explore how the level of equity and efficiency in vaccine coverage has evolved over time. The project takes a particular focus on “zero-dose” and not fully immunized children – two priorities for the Ministry of Health. Furthermore, as part of the MATCHES project we are adapting the VERSE Equity Tool to evaluate how the COVID-19 pandemic affected the access to quality maternal and child healthcare for different populations.
Nigeria
Applying the VERSE Equity Toolkit to analyzed Nigeria’s 2018 DHS data revealed that measures of socioeconomic status alone are insufficient for equity assessments. States with similar levels of coverage experienced different levels of equity in vaccine distribution, possibly due to demand-side constraints. Maternal education level was found to contribute significantly to vaccination inequity when controlling for socioeconomic status, residence, and other sociodemographic factors typically associated with varying vaccination rates. A link to the article will be provided shortly.
Uganda
Co-led with Makerere University, the VERSE project examines tradeoffs in equity and efficiency in vaccine coverage for priority vaccines, including the rotavirus vaccine introduced in the national program in 2018. The team is also adapting the VERSE toolkit to produce estimates from a health systems perspective, beyond immunization programs. Watch the video summary from the launch here.
The International Vaccine Access Center at Johns Hopkins University leads the VERSE project, funded by the Bill & Melinda Gates Foundation. Country-specific models and reports will be co-developed with our partners. The economic models will use outputs from disease models developed and managed by the Vaccine Impact Modeling Consortium.
Dr. Bryan Patenaude, Principal Investigator, bpatenaude@jhu.edu
Mr. Gatien de Broucker, Health Economist, gdebroucker@jhu.edu
Ms. Deborah Odihi, Health Economist, deborahodihi@jhu.edu
Ms. Salin Sriudomporn, Health Economist, ssriud@jhu.edu
Mr. Joshua Mak, Health Economist, joshua.mak@jhu.edu
We are looking to collaborate with anyone who is collecting or has national or sub-national data relevant to economic or vaccine coverage equity in Bangladesh, China, India, Nigeria, Uganda or globally/regionally (Sub-Saharan Africa & South-East Asia).
You can contact Bryan Patenaude at bpatenaude@jhu.edu
Read the VERSE overview paper detailing the methods to estimate and decompose inequality in vaccine coverage.
Watch the LNCT-VERSE webinar about how VERSE will measure and track vaccine equity.
Watch the special session introducing the VERSE toolkit at IHEA 2021.
