Americans are underinsured, and, as such, are required to pay for vaccines out-of-pocket. Others are responsible for paying high deductibles and co-pays. Although vaccinations usually induce long-term economic benefits, many governments struggle to pay the high short-term costs associated with labor and production. Consequently, many countries neglect to provide such services. According to a 2021 paper, vaccinations against haemophilus influenzae type b, hepatitis B, human papillomavirus, Japanese encephalitis, measles, neisseria meningitidis serogroup A, rotavirus, rubella, streptococcus pneumoniae, and yellow fever have prevented an estimated 50 million deaths from 2000 to 2019. The paper "represents the largest assessment of vaccine impact before COVID-19-related disruptions". According to a June 2022 study, COVID19 vaccinations prevented an additional 14.4 to 19.8 million deaths in 185 countries and territories from 8 December 2020 to 8 December 2021. The Coalition for Epidemic Preparedness Innovations published a study in The Lancet in 2018 which estimated the costs of developing vaccines for diseases that could escalate into global humanitarian crises. They focused on 11 diseases which cause relatively few deaths at present and primarily strike the poor which have been highlighted as pandemic risks: Crimean Congo hemorrhagic fever Chikungunya Ebola Lassa fever Marburg virus disease Middle East respiratory syndrome coronavirus Nipah virus infection Rift Valley fever Severe acute respiratory syndrome Severe fever with thrombocytopenia syndrome Zika They estimated that it would cost between $2.8 billion and $3.7 billion to develop at least one vaccine for each of them. This should be set against the potential cost of an outbreak. The 2003 SARS outbreak in East Asia cost $54 billion. Game theory uses utility functions to model costs and benefits, which may include financial and non-financial costs and benefits. In recent years, it has been argued that game theory can effectively be used to model vaccine uptake in societies. Researchers have used game theory for this purpose to analyse vaccination uptake in the context of diseases such as influenza and measles. Game theoretic analysis can be especially beneficial when a large and complex range of factors and parameters need to be taken into account by individuals in making vaccination decisions, and several options for vaccination are available, such as in the context of COVID-19 vaccination. Piraveenan et al. has argued that game theory, particularly when used in conjunction with models of bounded rationality of people, can be an effective tool in modelling and predicting COVID-19 vaccination uptake, which can