This review, and subsequent updates, ensures that immunization delivery cost evidence is globally accessible and easy to interpret

  • 498 resources reviewed (published and grey literature)

  • Data from 54 resources extracted


Methodology summary:

The systematic review aimed to answer a question frequently asked by global and country immunization stakeholders: What are the unit costs of vaccine delivery across different LMICs and through a variety of delivery strategies? The systematic review includes peer-reviewed articles/reports and grey literature that included immunization delivery costs published between January 2005 and January 2017. The review was limited to low- and middle-income country study settings, resulting in 54 articles/reports that presented unit delivery costs (i.e., delivery cost per dose, per capita, per full immunization of a vaccine or fully immunized child*, and per person in the target population). A reference list is available for download on this page.

Information extracted from the articles/reports includes metadata about the article/report’s attributes, details about the article/report’s costing methodology, and the reported cost results. All cost findings are also converted to a common year (2016) and currency (U.S. dollars (USD)) to ensure comparability across articles/reports and different settings. The quality of each article/report was assessed against a parsimonious set of quality criteria developed by the review team to capture methodological rigor and reporting standards, uncertainty of results, and risk of bias and limitations.

The extracted data is housed in the Immunization Delivery Cost Catalogue (IDCC), available as an interactive Microsoft Excel workbook and searchable web tool, making easily accessible only the most relevant and important information related to the unit cost results. It allows for comparability across numerous articles/reports and the variety of settings captured by the review, with all cost data presented in 2016 U.S. dollars. It is designed to allow country policymakers, researchers, advocates, donors, and other development partners with different data needs to search and analyze the data in the ways most useful to them.

For users interested in analyzed unit cost data, using data from the IDCC, ThinkWell developed seven delivery unit cost estimates by pooling four or more comparable unit costs from different articles/reports. These estimates are for delivery of specific vaccines or schedules, by delivery strategies and for different country income levels and regions. Comparability across unit cost estimates was checked across a number of different areas, including methods, contextual criteria and characteristics of the vaccine(s) costed (vaccines included and their delivery). For these pooled estimates, we developed cost ranges, the median, mean, 25th percentile and 75th percentile values. The estimates were validated with a group of eight immunization costing experts in March 2018. 


*Full immunization of a vaccine refers to all required doses of a specific vaccine (e.g. 3 doses of HPV). Fully immunized child refers to the provision of a certain number of doses of a specific vaccine(s) to a specific group by a clear point in time (e.g. infants who received one dose of BCG, three doses each of OPV, DPT, and Hepatitis B vaccines, and one dose of measles vaccine before reaching one year of age).


© 2018, Immunization Costing Action Network (ICAN), ThinkWell, LLC. All rights reserved.