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

  • 15,588 resources reviewed (published and grey literature)

  • Data from 61 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 low- and middle income (LMIC) countries and through a variety of delivery strategies? The systematic review includes peer-reviewed articles/reports and grey literature (resources) that included immunization delivery costs published between January 2005 and January 2018. The review was limited to LMIC study settings, resulting in 61 resources that presented immunization delivery unit 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 resources includes information on the study and country context, details about the costing methodology, and the reported cost results. All cost findings are also converted to a common year (2016) and currency (U.S. dollars (US$)) to ensure comparability across resources and different settings. The quality of each resource 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 resources and the variety of settings captured by the review, with all cost data presented in 2016 US$. 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, ThinkWell developed eight immunization delivery unit cost ranges (cost ranges) using four or more comparable unit costs from the IDCC. These cost ranges are for delivery of specific vaccines or schedules, and by different delivery strategies. Comparability across unit costs was checked across a number of different areas, including type of costs, delivery characteristics, and contextual information. For these cost ranges, we present the minimum, 25th percentile, 75th percentile, maximum, median, and mean values. The estimates were validated with an external group of immunization costing experts in March 2019. 


*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 all vaccines in the schedule before reaching one year of age), as opposed to a standard global definition, for example, of DTP3.


© 2019, Immunization Costing Action Network (ICAN), ThinkWell, LLC. All rights reserved.