Presentation (CTI)

OBJECTIVES: Immunisation programmes are widely recognised as one of the most cost-effective public health interventions. However, they often compete with other national priorities amid government budget constraints. Fiscal Health Modelling (FHM) quantifies government fiscal returns from immunisation programmes by capturing tax revenue gains, productivity preservation, and reduced government transfers beyond healthcare costs. While evidence on FHM is growing globally, the full landscape of this evidence base across countries, disease areas, and methodological approaches remains unmapped. This targeted literature review aims to systematically identify and characterise the global evidence on FHM for immunisation programmes.
METHODS: A targeted literature review (TLR) was conducted to identify and synthesise evidence informing FHM without time or geographical limits. A structured search strategy was undertaken in Embase, using controlled vocabulary and free text terms related to immunisation programmes. Complementary grey literature searches were conducted in Google Scholar. Study selection followed a two-stage process comprising title and abstract screening and subsequent full-text review by two independent reviewers.
RESULTS: A total of 38 unique studies published between 2010 and 2026 were identified across 26 countries. Geographic representation was diverse, including studies from Europe, North America, Asia, Africa, and Latin America. Disease coverage included general vaccination frameworks (8), HPV (6), rotavirus (6), COVID-19 (5), influenza (4), paediatric immunisation programmes (4), multi-vaccine programmes (1), and methodological reviews (3). Publication activity increased markedly since 2020, with 22 of 38 studies (58%) published between 2020-2026. Studies employed diverse methodological approaches, with fiscal benefit-cost ratios, net tax revenue gains, averted healthcare costs, and transfer reductions as common outcome measures.
CONCLUSIONS: FHM evidence is geographically diverse and growing, across multiple immunisation programmes and countries. This expanding evidence base demonstrates FHM's potential to inform governmental resource allocation decisions across diverse settings, supporting sustained strategic public investment in immunisation programmes globally.