Method: A targeted review of JCVI value definitions and utilisation of NICE methodologies was carried out. We specifically explored these definitions in the context of value assessment methodologies, the coronavirus pandemic, and the extent to which the value of prevention is appropriately captured.

Result: Vaccination programmes generate substantial ‘positive externalities’ over and above other medical interventions. The JCVI takes a narrow cost/QALY NHS perspective, whilst not accounting for wider social and economic benefits. Recent Office of National Statistics (ONS) and NHS coronavirus pandemic data now permits more detailed modelling and these data highlight the importance of vaccination and the need to incorporate additional value elements. Current literature and ISPOR guidelines show that a core values set for a multiple criteria decision analysis (MCDA) approach could be implemented. This might improve the quality of decision making, accountability, and equity in the assessment of new vaccination programmes.

These elements of value could be explicit modifiers to the cost-effectiveness WTP threshold like the deliberative elements currently used by NICE and the SMC. The JCVI has previously applied modifiers in the evaluation of Meningitis B vaccines.

Conclusion: Optimal allocation of scarce NHS resources whilst achieving the UK Government’s vision of prioritising prevention requires updated definitions of value. We suggest a flexible approach to capturing value to accommodate new vaccines, pandemics, and the changing preferences of society. Additional value elements should be formally included in JCVI evaluations to capture this wider system and societal benefit.