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

Radhika Gharpure; Angela Oloo Akumu; Jeanette Dawa; Stacie Gobin; Bishwa B Adhikari; Kathryn E Lafond; Leah S Fischer; Harriet Mirieri; Henry Mwazighe; Collins Tabu; Rose Jalang'o; Peter Kamau; Catherine Silali; Rosalia Kalani; Pauline Oginga; Isaac Jewa; Virginia Njenga; Malembe S Ebama; Joseph S Bresee; M Kariuki Njenga; Eric Osoro; Martin I Meltzer; Gideon O Emukule

doi:10.1016/j.vaccine.2023.12.029

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

Vaccine. 2023 Dec 27:S0264-410X(23)01475-5. doi: 10.1016/j.vaccine.2023.12.029. Online ahead of print.

Authors

Radhika Gharpure¹, Angela Oloo Akumu², Jeanette Dawa², Stacie Gobin³, Bishwa B Adhikari⁴, Kathryn E Lafond⁴, Leah S Fischer⁴, Harriet Mirieri², Henry Mwazighe², Collins Tabu⁵, Rose Jalang'o⁵, Peter Kamau⁵, Catherine Silali⁵, Rosalia Kalani⁶, Pauline Oginga⁷, Isaac Jewa⁷, Virginia Njenga⁸, Malembe S Ebama⁹, Joseph S Bresee⁹, M Kariuki Njenga¹⁰, Eric Osoro¹⁰, Martin I Meltzer⁴, Gideon O Emukule¹¹

Affiliations

¹ U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: rgharpure@cdc.gov.
² Washington State University (WSU) Global Health Kenya, Nairobi, Kenya.
³ Gobin Global, LLC, Asheville, NC, USA; Partnership for Influenza Vaccine Introduction, Task Force for Global Health, Atlanta, GA, USA.
⁴ U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.
⁵ National Vaccines and Immunization Program, Ministry of Health, Kenya.
⁶ Division of Disease Surveillance and Response, Ministry of Health, Kenya.
⁷ Department of Health, Mombasa County, Kenya.
⁸ Department of Health, Nakuru County, Kenya.
⁹ Partnership for Influenza Vaccine Introduction, Task Force for Global Health, Atlanta, GA, USA.
¹⁰ Washington State University (WSU) Global Health Kenya, Nairobi, Kenya; Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, WA, USA.
¹¹ U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA; U.S. Centers for Disease Control and Prevention, Nairobi, Kenya.

PMID: 38154992
DOI: 10.1016/j.vaccine.2023.12.029

Abstract

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: 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: 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: 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.

Keywords: Economics; Expenditures; Influenza vaccine; Pediatric; Vaccination.

Published by Elsevier Ltd.