13 June 2018
The UK public has a clear preference for funding vaccination programmes which protect young children against severe diseases, finds a new study that considered the public’s preferences on vaccines available on the NHS. The study suggests that the public’s preferences about which vaccines are made available on the NHS, particularly children, are not reflected by the current approach. The Meningitis Research Foundation (MRF)-funded study, led by University of Bristol researchers, is published today [13 June] in PLOS ONE.
Decisions regarding which vaccines the government fund are determined by cost-effectiveness analysis. For vaccines, this involves counting the cost of introducing a vaccine, versus the health benefits gained. Measuring such benefits is controversial, partly because assumptions are made about public preferences.
The team interviewed members of the public to determine how they think policy makers should prioritise vaccinations. They found a general consensus that policy makers should prioritise vaccinations preventing severe disease in children as well as disease with high incidence, compared to those that fund milder infections.
Participants also agreed that decisions on determining whether a vaccine should be made available on the NHS should be based on a number of factors including, age, the impact on families caring long-term for a family member affected by a vaccine-preventable illness or disability, and social groups.
Participants indicated a preference for funding vaccination programmes that protect specific age groups considered to be most vulnerable to disease, particularly the very young and socially disadvantaged children who often have a lower underlying health status and should therefore be prioritised when targeting health benefits.
The findings indicate that the current approach may need to be refined when considering the benefit from childhood vaccinations.
Dr Gemma Lasseter, Senior Research Associate at the NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol said, “There is increasing debate about whether the QALY approach is appropriate for assessing the benefit from childhood vaccinations as vaccines against rare, but severe childhood illnesses such as meningitis and septicaemia, may struggle to get approved compared to those that prevent very common, but mild illnesses. In the future, this research could help ensure that policy decisions on vaccines consider real life public preferences and that vaccines are prioritised as the public want them to be - potentially shaping the future of vaccine availability.”
Vinny Smith, Chief Executive at MRF: said, “For a long time we have called for a reform of the cost effectiveness rules that put vaccines that prevent uncommon, severe childhood disease at a disadvantage.
“The MenB vaccine is one example of how flawed the system is. When the vaccine was first licensed, the UK government’s vaccine advisory committee did not recommend introducing the vaccine on the NHS based on cost. MRF fought hard to change this by submitting evidence highlighting the devastating burden of meningococcal meningitis and septicaemia on individuals and their families. Introducing the MenB vaccine for babies in 2015 was a major step forward, but offering vaccination for this age group alone will only prevent around a quarter of cases and if the vaccine rules had been fairer, more children could have been protected.
“Vaccination is the only way to prevent diseases like meningitis, and this study shows that the public value protection from severe disease, particularly for children. The rules that govern access to vaccines do not reflect the public’s preferences.”
Paper: The views of the general public on prioritising vaccination programmes against childhood diseases: A qualitative study' by Gemma Lasseter, Hareth Al-Janabi, Caroline L. Trotter, Fran E. Carroll and Hannah Christensen in PLOS ONE.
There is currently a UK government consultation on a report about the way decisions are made about vaccines. The Cost Effectiveness Methodology for Immunisation Programmes and Procurement (CEMIPP) working group was set up in 2014 to consider whether the method for making decisions about which vaccines to fund should change. The tragic death of a young girl, Faye Burdett, led to a huge public outcry and a petition with over 820,000 people calling for greater access to the MenB vaccine.
The UK government promised petitioners that a report produced by CEMIPP would be published in 2016. After a long delay this has now been published and Meningitis Research Foundation has been asked to respond to a consultation on the report and represent public views.
If implemented as a package, the current report recommendations would result in the opposite of what the petitioners wanted and would actually make it much harder to get vaccines introduced, not easier. The public are invited to have their say at www.meningitis.org/survey
About the NIHR
The National Institute for Health Research (NIHR): improving the health and wealth of the nation through research.
Established by the Department of Health and Social Care (DHSC), the NIHR:
- funds high quality research to improve health
- trains and supports health researchers
- provides world-class research facilities
- works with the life sciences industry and charities to benefit all
- involves patients and the public at every step.
For further information, visit the NIHR website www.nihr.ac.uk.
This research was funded by the NIHR Health Protection Research Unit in Evaluation of Interventions and supported by the Meningitis Research Foundation (grant number 1506.0).