Costs of seasonal influenza vaccine delivery in a pediatric demonstration project for children aged 6-23 months - Nakuru and Mombasa Counties, Kenya, 2019-2021.

Economics Expenditures Influenza vaccine Pediatric Vaccination

Journal

Vaccine
ISSN: 1873-2518
Titre abrégé: Vaccine
Pays: Netherlands
ID NLM: 8406899

Informations de publication

Date de publication:
27 Dec 2023
Historique:
received: 28 08 2023
revised: 04 12 2023
accepted: 07 12 2023
medline: 29 12 2023
pubmed: 29 12 2023
entrez: 28 12 2023
Statut: aheadofprint

Résumé

During November 2019-October 2021, a pediatric influenza vaccination demonstration project was conducted in four sub-counties in Kenya. The demonstration piloted two different delivery strategies: year-round vaccination and a four-month vaccination campaign. Our objective was to compare the costs of both delivery strategies. Cost data were collected using standardized questionnaires and extracted from government and project accounting records. We reported total costs and costs per vaccine dose administered by delivery strategy from the Kenyan government perspective in 2021 US$. Costs were separated into financial costs (monetary expenditures) and economic costs (financial costs plus the value of existing resources). We also separated costs by administrative level (national, regional, county, sub-county, and health facility) and program activity (advocacy and social mobilization; training; distribution, storage, and waste management; service delivery; monitoring; and supervision). The total estimated cost of the pediatric influenza demonstration project was US$ 225,269 (financial) and US$ 326,691 (economic) for the year-round delivery strategy (30,397 vaccine doses administered), compared with US$ 214,753 (financial) and US$ 242,385 (economic) for the campaign strategy (25,404 doses administered). Vaccine purchase represented the largest proportion of costs for both strategies. Excluding vaccine purchase, the cost per dose administered was US$ 1.58 (financial) and US$ 5.84 (economic) for the year-round strategy and US$ 2.89 (financial) and US$ 4.56 (economic) for the campaign strategy. The financial cost per dose was 83% higher for the campaign strategy than the year-round strategy due to larger expenditures for advocacy and social mobilization, training, and hiring of surge staff for service delivery. However, the economic cost per dose was more comparable for both strategies (year-round 22% higher than campaign), balanced by higher costs of operating equipment and monitoring activities for the year-round strategy. These delivery cost data provide real-world evidence to inform pediatric influenza vaccine introduction in Kenya.

Sections du résumé

BACKGROUND BACKGROUND
During November 2019-October 2021, a pediatric influenza vaccination demonstration project was conducted in four sub-counties in Kenya. The demonstration piloted two different delivery strategies: year-round vaccination and a four-month vaccination campaign. Our objective was to compare the costs of both delivery strategies.
METHODS METHODS
Cost data were collected using standardized questionnaires and extracted from government and project accounting records. We reported total costs and costs per vaccine dose administered by delivery strategy from the Kenyan government perspective in 2021 US$. Costs were separated into financial costs (monetary expenditures) and economic costs (financial costs plus the value of existing resources). We also separated costs by administrative level (national, regional, county, sub-county, and health facility) and program activity (advocacy and social mobilization; training; distribution, storage, and waste management; service delivery; monitoring; and supervision).
RESULTS RESULTS
The total estimated cost of the pediatric influenza demonstration project was US$ 225,269 (financial) and US$ 326,691 (economic) for the year-round delivery strategy (30,397 vaccine doses administered), compared with US$ 214,753 (financial) and US$ 242,385 (economic) for the campaign strategy (25,404 doses administered). Vaccine purchase represented the largest proportion of costs for both strategies. Excluding vaccine purchase, the cost per dose administered was US$ 1.58 (financial) and US$ 5.84 (economic) for the year-round strategy and US$ 2.89 (financial) and US$ 4.56 (economic) for the campaign strategy.
CONCLUSIONS CONCLUSIONS
The financial cost per dose was 83% higher for the campaign strategy than the year-round strategy due to larger expenditures for advocacy and social mobilization, training, and hiring of surge staff for service delivery. However, the economic cost per dose was more comparable for both strategies (year-round 22% higher than campaign), balanced by higher costs of operating equipment and monitoring activities for the year-round strategy. These delivery cost data provide real-world evidence to inform pediatric influenza vaccine introduction in Kenya.

Identifiants

pubmed: 38154992
pii: S0264-410X(23)01475-5
doi: 10.1016/j.vaccine.2023.12.029
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Radhika Gharpure (R)

U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: rgharpure@cdc.gov.

Angela Oloo Akumu (AO)

Washington State University (WSU) Global Health Kenya, Nairobi, Kenya.

Jeanette Dawa (J)

Washington State University (WSU) Global Health Kenya, Nairobi, Kenya.

Stacie Gobin (S)

Gobin Global, LLC, Asheville, NC, USA; Partnership for Influenza Vaccine Introduction, Task Force for Global Health, Atlanta, GA, USA.

Bishwa B Adhikari (BB)

U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.

Kathryn E Lafond (KE)

U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.

Leah S Fischer (LS)

U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.

Harriet Mirieri (H)

Washington State University (WSU) Global Health Kenya, Nairobi, Kenya.

Henry Mwazighe (H)

Washington State University (WSU) Global Health Kenya, Nairobi, Kenya.

Collins Tabu (C)

National Vaccines and Immunization Program, Ministry of Health, Kenya.

Rose Jalang'o (R)

National Vaccines and Immunization Program, Ministry of Health, Kenya.

Peter Kamau (P)

National Vaccines and Immunization Program, Ministry of Health, Kenya.

Catherine Silali (C)

National Vaccines and Immunization Program, Ministry of Health, Kenya.

Rosalia Kalani (R)

Division of Disease Surveillance and Response, Ministry of Health, Kenya.

Pauline Oginga (P)

Department of Health, Mombasa County, Kenya.

Isaac Jewa (I)

Department of Health, Mombasa County, Kenya.

Virginia Njenga (V)

Department of Health, Nakuru County, Kenya.

Malembe S Ebama (MS)

Partnership for Influenza Vaccine Introduction, Task Force for Global Health, Atlanta, GA, USA.

Joseph S Bresee (JS)

Partnership for Influenza Vaccine Introduction, Task Force for Global Health, Atlanta, GA, USA.

M Kariuki Njenga (MK)

Washington State University (WSU) Global Health Kenya, Nairobi, Kenya; Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, WA, USA.

Eric Osoro (E)

Washington State University (WSU) Global Health Kenya, Nairobi, Kenya; Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, WA, USA.

Martin I Meltzer (MI)

U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.

Gideon O Emukule (GO)

U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA; U.S. Centers for Disease Control and Prevention, Nairobi, Kenya.

Classifications MeSH