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Value of Vaccines 2020

Beyond childhood: the case for life-course immunisation

Image provided by IFPMA

Laetitia Bigger

Director, Vaccines Policy, International Federation of Pharmaceutical Manufacturers and Associations (IFPMA)

Is it possible to protect all populations from certain diseases, while keeping health system expenses within a reasonable range? Let’s look at implementing a life-course approach to immunisation…


The global population continues to age. In 2020, children under five years will be outnumbered by people of 60 or more years. This means prevention of disease is becoming more important. A life-course approach to immunisation (LCI) promotes individual and population health, and emphasises the prevention of disease.

So, what exactly is a life-course approach to immunisation? ‘The life-course approach to immunisation recognises the role of immunisation as a strategy to prevent disease and maximise health over one’s entire life, regardless of an individual’s age and includes all populations.’

Policy framework for implementing a life-course approach to immunisation

Immunisation beyond infancy

Worldwide, vaccines save between two and three million lives each year. Immunisation is considered one of the most effective public health achievements of modern society. However, until recently, the target has only concerned children under five years of age, and little focus has been given beyond infancy. As research has shown that pregnant women, adolescents, older adults, people with certain chronic conditions, caregivers, healthcare professionals, and vulnerable and marginalised communities, face an increased risk of contracting vaccine-preventable diseases and can greatly benefit from an LCI approach. While this is recognised at global level, progress within individual countries has been slow.

A greater vaccine uptake contributes to a positive impact on education, workforce productivity, and ultimately an increased GDP.

How can LCI benefit communities as a whole?

Improving immunisation rates in the community has the potential to protect vaccinated individuals and vulnerable populations, like children and immunocompromised individuals, who are at high risk for infections.

Investing in an LCI approach on a health system level can support universal health coverage by reaching people who may not have access to primary healthcare services by providing infrastructure.

An important feature and benefit of LCI is the indirect impact of some vaccines on antimicrobial resistance (AMR). Increased uptake of AMR-related vaccines throughout the life course, as a complementary tool to mitigate the threat of AMR, is essential due to antibiotics becoming gradually less effective against resistant bacteria. It is critical to increase the uptake and coverage of existing vaccines, to prevent disease and reduce demand for antibiotics, safeguarding their effectiveness.

Progress of countries against the policy checklist

Creating a healthy and prosperous society

The World Health Organization (WHO) estimates the global yearly return on investments to vaccination is 12-18%[6]. For every €1 invested, the government gets back €4.02 of economic revenue.

A greater vaccine uptake contributes to a positive impact on education, workforce productivity, and ultimately an increased GDP. Therefore, LCI reduces the burden on healthcare services, promotes healthy ageing and addresses health risks like infectious diseases and AMR that impact the global economy. LCI is thus recognised a cost-effective intervention.

Harnessing the benefit of LCI will require policy changes and innovative approaches. A report from The Health Policy Partnership supported by IFPMA showcases important lessons from six countries who are in different stages of implementing LCI. It identifies five key policy areas which, if accomplished, would lead to building healthier communities and nations with a strong vaccination foundation – a foundation of primary healthcare.

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