Global immunisation planning and economic development potential: a panel data analysis for the macroeconomic impact of hepatitis B vaccination from 2000 to 2018

BACKGROUND: The Immunisation Agenda 2030, led by the World Health Organisation (WHO), outlines a ten-year strategy to ensure universal access to vaccines worldwide to improve health and well-being. The hepatitis B virus (HBV) vaccine, included in the Global Alliance for Vaccines and Immunisation (Gavi) pentavalent vaccine, has been successfully introduced in many low-income countries since 2000. Despite its recognised cost-effectiveness in enhancing health capital, the economic pathways through which vaccination rate affects development remain underexplored. This study aims to examine the effect of vaccination rate on gross domestic product (GDP) growth and its underlying mechanisms after the launch of Gavi. METHODS: Data were mainly obtained from WHO, World Development Indicators (WDI), Penn World Table 10.0 (PWT 10.0), WHO and UNICEF Estimates for National Immunisation Coverage (WUENIC). A conditional convergence model was used to evaluate the association between the three-dose vaccine of HBV (HBV3) vaccination rate and GDP growth from 2000 to 2018 across countries. Guided by Grossman's health capital theory, the study further explored mediation pathways via the under-5 mortality rate and the number of persons engaged. Income-group-based heterogeneity analyses were also conducted. RESULTS: HBV3 vaccination rates rose globally during the study period, with the rate gap across income groups narrowing from over 20% to around 10%. A 1% increase in HBV3 vaccination rate was associated with a 1.17% GDP per capita convergence rate per year (p < 0.01). Vaccination rate was negatively associated with the under-5 mortality rate (β=-0.104, p < 0.01) and positively with the number of persons engaged (β = 6.935, p < 0.01), though mediation was only partial. Heterogeneity analyses by income group revealed that the economic impact of vaccination rate was significantly concentrated (β = 0.0164, p < 0.01) in lower-middle-income countries (LMICs). CONCLUSIONS: These findings suggest that improved HBV3 vaccination rate promotes GDP growth through enhanced health capital, especially in LMICs. Therefore, sustained investments in routine immunisation are crucial for maximising economic and health returns and addressing vaccine inequities. However, the limitations of the analytical framework and data accessibility hinder solid conclusions regarding the long-term economic impacts driven by delayed health benefits.