If you have just had a child, especially if it is a boy, you will have to pay around 1,000 euros if you want to give him all the vaccinations that the pediatrician will recommend. There are four serums that doctors recommend parents administer to children but that the public system has not financed: meningococcus B, rotavirus, human papillomavirus (in males) and influenza up to 59 months of age. The economic sum that this implies ranges between 797.79 and 973.5 euros, depending on the commercial brand that you want to buy at the pharmacy.
The decision not to finance these vaccines is not a widespread trend in Europe, quite the contrary. Countries like the United Kingdom or Austria finance all of the aforementioned, while Italy and Portugal only leave flu in children out of public coverage. In general terms, within the 27, meningitis B is funded in 10 countries (France has just joined the list), rotavirus in 14 and Human Papillomavirus for men in 17 Member States.
In fact, the problem of inequality is not just something that stays on the borders of different countries. In Spain, both the Ministry of Health and the autonomous communities agreed on a lifelong vaccination schedule. However, this agreement seems to be minimal. For example, if you live in Madrid or Valencia, you will have to pay for the meningococcal B vaccine (up to 318 euros), while if you live in Valladolid or Seville, it will be free. In total, there are four communities that have expanded the range of financed vaccines for menigococcus B: Andalusia, the Canary Islands, Castilla y León and Catalonia.
The decision not to finance these vaccines but to allow their free sale (always under the pediatrician’s recommendation) in pharmacies creates a moral debate. A family with limited financial resources will have a harder time protecting their children, while another could do so without too much trouble. In fact, from a public health point of view, it also makes no sense to limit vaccination for economic reasons.
The autonomous communities allocated 378 million euros for vaccines throughout 2021. This means 1.8% of total pharmaceutical spending in Spain (pharmacy and hospital), which amounted to 20,000 million euros in the same year. If the weight of spending on vaccines is measured with total public health spending, which in 2021 was 81.6 billion euros, the percentage drops to 0.46%.
For 2022 there is a budget increase for this item, at a general level, of 21%, reaching 459 million euros. One of the reasons is the arrival of a new vaccine in Spain, that of Herpes Zoster, which will be financed for those over 65 years of age. However, there will not be an equal implementation in all communities. Madrid will be the first to start with the implementation, the rest of the communities will be added throughout this year. Both in this autonomy and in Castilla y León, it is where the budget for vaccines rises the most in 2022, while in Murcia it is where it falls the most (22%).
The lifelong vaccination schedule in Spain, in its update for 2021, includes 16 types of diseases for which vaccines are financed. According to the Ministry’s own calculations, collected in an article in the Spanish Journal of Public Health, the cost of vaccinating a citizen is less than what parents will have to pay for the aforementioned vaccines, which are not financed but are recommended from the Spanish Association of Pediatrics in its particular vaccination calendar.
The numbers handled by the department of Carolina Darias indicate that vaccinating a man until his death costs 625.89 euros, of which 162 are administration costs (staff, material…). For its part, vaccinating a woman throughout her life costs 726.06 euros, of which 186 are administration costs. These prices are calculated based on the cost of vaccines in 2019. In addition, it is taken into account that the person to be immunized is healthy. Otherwise, for example in an immunosuppressed person, the cost is 1,469.72 euros.
Pediatricians ask for efforts
In the current situation, with vaccines not financed by the National Health System for children, pediatricians are very clear: an effort must be made. “Some requests are still pending, such as whooping cough (Tdap) vaccination in adolescents and human papillomavirus vaccination in 12-year-old boys, anti-rotavirus and anti-meningococcal B vaccination in infants, influenza vaccination in all children aged six to 59 months of age and also immunization against meningococcal with quadrivalent vaccine (MenACWY), at 12 months of age. Therefore, it is considered desirable that a collective economic effort be made, by the communities and the Ministry, “to allow the financing of a complete systematic calendar for children living in Spain”, points out the Spanish Association of Pediatrics.
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