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. 2025 Dec;24(1):924-935.
doi: 10.1080/14760584.2025.2564170. Epub 2025 Sep 24.

The public health and economic impact of the Greek pediatric national immunization program

Ilias Gountas  1 , Sandra E Talbird  2 , Justin Carrico  2 , Cameron Cook  2 , Anastasis Skroumpelos  1 , Eleni Boutselakou  1 , Georgios Trimis  1 , Athanasios Michos  3 , Ioanna Pavlopoulou  4 , Goran Bencina  5 , Ugne Sabale  6
Affiliations
Free article

The public health and economic impact of the Greek pediatric national immunization program

Ilias Gountas et al. Expert Rev Vaccines. 2025 Dec.
Free article

Abstract

Background: Vaccines are one of the most effective healthcare tools to prevent morbidity and mortality from infectious diseases.

Research design and methods: A decision tree model was used to evaluate the public health and economic impact of the Greek pediatric national immunization program (NIP) over the lifetime of the 2022 Greek birth cohort. The model included nine Greek NIP routine vaccines for children aged 2 months to 11 years, targeting 14 vaccine-preventable diseases: diphtheria, hepatitis A, hepatitis B, Haemophilus influenzae type B, measles, meningococcal disease, mumps, pertussis, pneumococcal disease, poliomyelitis, rotavirus, rubella, tetanus, and varicella. The outcomes (discounted 3% annually) included estimated disease cases and deaths averted, life-years (LYs) and quality-adjusted life-years (QALYs) gained, total costs averted (2022 euros), and benefit-cost ratios (BCR) from healthcare-sector and societal perspectives.

Results: The Greek pediatric NIP prevented 447,221 disease cases and 242 deaths, resulting in 6,682 LYs and 9,741 total QALYs gained for the 2022 birth cohort. Costs averted were €23.2 million (BCR = 1.3) from the healthcare-sector perspective; costs averted from the societal perspective were €201.4 million (BCR = 3.1), plus €514.0 million in value of QALYs gained (BCR = 8.5).

Conclusion: The Greek pediatric NIP provides extensive public health and economic benefits for Greece by reducing morbidity and mortality from vaccine-preventable diseases.

Keywords: Cost-benefit analysis; Greece; pediatric immunization programs; public health; vaccine.

Plain language summary

Immunization programs are essential public health measures used by countries to reduce vaccine-preventable diseases. This study is the first to estimate the public health and economic impact of the Greek pediatric national immunization program (NIP). The analysis adapted a previously published model to include nine vaccines (targeting 14 vaccine-preventable diseases) from the Greek pediatric NIP for children aged 2 months to 11 years. The number of cases and deaths over the lifetime of Greek children born in 2022 was calculated by applying disease and death rates with or without a NIP to the 2022 birth cohort. Our results show that continuous implementation of the Greek pediatric NIP is estimated to prevent 447,221 cases of disease, avert 242 deaths, and save over €200 million in costs. Taking into account vaccination program costs, reduced treatment expenses, reduced work loss, improved quality-of-life, and fewer deaths, every €1 invested in immunizations is projected to yield €8.5 in societal cost-savings. The continued investment in the Greek pediatric NIP will not only prevent illness and death from vaccine-preventable diseases but also provide economic benefits for Greece.

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