Vaccinate the rich!

The societal benefits of seasonal influenza vaccination in a healthy working adult is estimated across various studies as ~$45 per year based largely on reduction in working days lost. The cost of influenza vaccination from Lloyd pharmacy is now £5 (~$8). 40.9% of total national income is (ultimately) taken as tax in the UK, so tax revenue lost is 0.4*$45 = $18. So universal influenza vaccination of workers should make the government a net saving of at least $10 per person (more if they are in an existing high risk group).

There are some hidden costs I’ve not considered, such as the costs of getting to the pharmacy, and tax revenues may not fall as fast as costs, if employers bear some of the cost through (non-statutory) sick leave arrangements (given companies pay a lower rate of tax than individuals). On the other hand the majority of health care workers don’t get a seasonal vaccine (even though it is free to them), and in most cases the government pays the full brunt of any loss of earnings from this group.

Obviously income distribution plays a role, if low income people don’t work it has minimal effect on tax revenues, the societal loss is thus less (even if for the individual it is as bad, or likely worse).

By my back of the envelope calculations vaccinating all higher rate tax payers against seasonal influenza in the UK would generate enough additional tax revenue to pay to vaccinate everyone else from influenza (including the current vaccination program).

I’m guessing free influenza vaccines for higher rate tax payers wouldn’t fly politically, nor mandatory vaccination for health care workers, nor removing sick leave arrangements for vaccine preventable diseases.

Probably I shouldn’t go into politics.

2 thoughts on “Vaccinate the rich!

  1. niq

    Yay, bring on the ‘flu superbug!

    (mass-vaccination programmes hasten the evolution of vaccine-resistant strains of bugs)

  2. Simon Waters Post author

    We already vaccinate 65% of over 65’s and 40% of other high risk groups so we already have mass vaccination for influenza.

    However I don’t believe mass vaccination encourages resistance, and I can’t find any reference to such a statement in the medical literature. Do you have such a reference?

    Clearly it isn’t universally true for vaccination or we’d all be suffering from novel forms of smallpox, measles, mumps, chickenpox, rota virus, polio, HPV, Rubella, Meningitis C, tetanus, pertussis etc. Where as vaccination against these disorders remains extremely effective (except for smallpox, where no widespread vaccination takes place as far as I know), and the total infectious disease burden is less than before effective vaccination.

    Diseases which are highly contagious naturally result in high levels of immunity, through infection. So if immunisation bred superbugs, so would the natural spread of a disease like smallpox. I suspect influenza is similar, in that 35% of unvaccinated individuals get influenza in a given year, so would be “mass vaccinated” when viewing the situation in the next year. I suspect vaccination reduces the opportunity for mutation, whilst not substantially altering selective pressure for these types of infection.


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