Cost of vaccine delivery strategies in low- and middle-income countries during the COVID-19 pandemic

Christina Banks,Allison Portnoy,Flavia Moi,Laura Boonstoppel,Logan Brenzel,Stephen C Resch

doi:10.1016/j.vaccine.2021.06.076

Christina Banks, Allison Portnoy + Show 4 more

Open Access

https://doi.org/10.1016/j.vaccine.2021.06.076

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Journal: Vaccine	Publication Date: Jun 29, 2021
Citations: 6	License type: cc-by

Affiliation: Bill & Melinda Gates Foundation

Abstract

BackgroundThe COVID-19 pandemic has disrupted immunization services critical to the prevention of vaccine-preventable diseases in many low- and middle- income countries around the world. These services will need to be modified in order to minimize COVID-19 transmission and ensure the safety of health workers and the community. Additional budget will be required to implement these modifications that ensure safe delivery. MethodsUsing a simple modeling analysis, we estimated the additional resource requirements associated with modifications to supplementary immunization activities (campaigns) and routine immunization services via fixed sites and outreach in 2020 US dollars. We considered the following four categories of costs: (1) personal protective equipment (PPE) & infection prevention and control (IPC) measures for immunization sessions; (2) physical distancing and screening during immunization sessions; (3) delivery strategy changes, such as changes in session sizes and frequency; and (4) other operational cost increases, including additional social mobilization, training, and hazard pay to compensate health workers. ResultsWe found that implementing a range of measures to protect health workers and communities from COVID-19 transmission could result in a per-facility start-up cost of $466–799 for routine fixed-site delivery and $12–220 for routine outreach delivery, and $12–108 per immunization campaign site. A recurrent monthly cost of $137–1,024 for fixed-site delivery and $152–848 for outreach delivery per facility could be incurred, and a $0.32–0.85 increase in the cost per dose during campaigns. ConclusionsBy illustrating potential cost implications of providing immunization services through a range of strategies in a safe manner, these estimates can provide a benchmark for program managers and policy makers on the additional budget required. These findings can help country practitioners and global development partners planning the continuation of immunization services in the context of COVID-19.

Highlights

The COVID-19 pandemic has been disrupting immunization services that are critical to the prevention of morbidity and mortality from vaccine-preventable diseases in many low- and middleincome countries (LMICs) around the world [1]
This study found that implementing a range of measures to protect health workers and communities from COVID-19 transmission could result in a per-facility start-up cost of $466–799 for routine fixed-site delivery and $12–220 for routine outreach delivery, and $12–108 per immunization campaign site
We presented a case study in Tanzania in order to provide a real-world example of the cost implications investigated in our analysis; alternative country settings may have different cost implications compared to this case study

Summary

Introduction

The COVID-19 pandemic has been disrupting immunization services that are critical to the prevention of morbidity and mortality from vaccine-preventable diseases in many low- and middleincome countries (LMICs) around the world [1]. In order to maintain or restore immunization coverage levels while minimizing COVID-19 transmission and ensuring the safety of health workers and the community, modifications in the way vaccines are delivered are required The COVID-19 pandemic has disrupted immunization services critical to the prevention of vaccine-preventable diseases in many low- and middle- income countries around the world These services will need to be modified in order to minimize COVID-19 transmission and ensure the safety of health workers and the community. Conclusions: By illustrating potential cost implications of providing immunization services through a range of strategies in a safe manner, these estimates can provide a benchmark for program managers and policy makers on the additional budget required These findings can help country practitioners and global development partners planning the continuation of immunization services in the context of COVID-19

Methods

Results

Conclusion