The Societal Value of Vaccines: Expert-Based Conceptual Framework and Methods Using COVID-19 Vaccines as A Case Study

This research has not been peer-reviewed. It is a preliminary report that should not be regarded as conclusive, guide clinical practice or health-related behaviour, or be reported in news media as established information.

Health technology assessments (HTAs) of vaccines typically focus on the direct health benefits to individuals and healthcare systems. COVID-19 highlighted the widespread societal impact of infectious diseases and the value of vaccines in averting adverse clinical consequences and in maintaining or resuming social and economic activities. Using COVID-19 as a case study, this research work aimed to set forth a conceptual framework capturing the broader value elements of vaccines and to identify appropriate methods to quantify value elements not routinely considered in HTAs. A two-step approach was adopted combining a targeted literature review and three rounds of expert elicitation based on a modified Delphi method, leading to a conceptual framework of 30 value elements related to broader health effects, societal and economic impact, public finances, and uncertainty value. When applying the framework to COVID-19 vaccines in post-pandemic settings, 13 value elements were consensually rated highly important by the experts for consideration in HTAs. The experts reviewed over 10 methods that could be leveraged to quantify broader value elements and provided technical forward-looking recommendations. Limitations of the framework and the identified methods were discussed. This study supplements on-going efforts aimed towards a broader recognition of the full societal value of vaccines.

Author list



  1. Health Economics and Outcomes Research, Pfizer Inc, New York, USA
  2. Health & Value, Pfizer Ltd, Tadworth, UK
  3. Office of Health Economics, London SW1E 6QT, UK
  4. Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, USA
  5. Centre for Health Economics, Alcuin A Block, University of York, Heslington, York YO10 5DD, UK.
  6. Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, UK
  7. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
  8. Health Analytics, Lane Clark & Peacock, London, UK
  9. The Patients Association, PO Box 935, Harrow, Middlesex, HA1 3YJ, UK
  10. Programme for Global Health, Royal Institute of International Affairs, Chatham House, London, UK
  11. Evidence, Value and Access by PPD, Evidera, London, UK
  12. Evidence, Value and Access by PPD, Evidera, Budapest, Hungary
  13. Institute for Social and Economic Research and Policy, Graduate School of Arts and Science, Columbia University, New York, USA


Manuela Di Fusco1,*, Diana Mendes2, Lotte Steuten3, David E Bloom4, Michael Drummond5, Katharina Hauck6, Jona- than Pearson-Stuttard7,8, Rachel Power9, David Salisbury10, Adrian Towse3, Julie Roiz11, Gabor Szabo12, Jingyan Yang1,13, Kinga Marczell12

Novel Coronavirus SARS-CoV-2