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Vaccine. 2018 Jun 14;36(25):3641-3649. doi: 10.1016/j.vaccine.2018.05.030. Epub 2018 May 10.

Systematic review of the incremental costs of interventions that increase immunization coverage.

Author information

1
Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA; Department of Maternal and Child Health, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA. Electronic address: ozawa@unc.edu.
2
Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA.
3
Kid Risk, Inc., Columbus, OH, USA.

Abstract

Achieving and maintaining high vaccination coverage requires investments, but the costs and effectiveness of interventions to increase coverage remain poorly characterized. We conducted a systematic review of the literature to identify peer-reviewed studies published in English that reported interventions aimed at increasing immunization coverage and the associated costs and effectiveness of the interventions. We found limited information in the literature, with many studies reporting effectiveness estimates, but not providing cost information. Using the available data, we developed a cost function to support future programmatic decisions about investments in interventions to increase immunization coverage for relatively low and high-income countries. The cost function estimates the non-vaccine cost per dose of interventions to increase absolute immunization coverage by one percent, through either campaigns or routine immunization. The cost per dose per percent increase in absolute coverage increased with higher baseline coverage, demonstrating increasing incremental costs required to reach higher coverage levels. Future studies should evaluate the performance of the cost function and add to the database of available evidence to better characterize heterogeneity in costs and generalizability of the cost function.

KEYWORDS:

Cost; Effectiveness; Intervention; Review; Vaccination

PMID:
29754699
DOI:
10.1016/j.vaccine.2018.05.030
[Indexed for MEDLINE]

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