Update of PAHO's ProVac e-toolkit

Launch of the training modules on PAHO’s ProVac e-toolkit

The e-toolkit is available in English, French and Spanish from:



Background: PAHO ProVac Initiative


The Pan American Health Organization (PAHO) created the ProVac Initiative in 2004 with the goal of strengthening the evidence-based decision making on immunization to sustain and further the public health impact of the Expanded Programs of Immunization. 

ProVac’s areas of work include economics of new vaccine introduction, immunization program performance optimization, and strengthening of regional and national advisory bodies.

The ProVac trainings have been a critical component of the capacity building provided to countries of Latin America and the Caribbean, along with direct technical support for conducting cost-effectiveness analyses for new vaccine introductions and costing studies of immunization programs. 

To date, ProVac has supported 43 country-level vaccine cost-effectiveness analyses supported, 4 program costing studies, and conducted 6 regional workshops including over 300 participants from 25 countries. In its support for vaccine introduction, ProVac has focused on influenza, Haemophilus influenza type b, pneumococcal, rotavirus, human papilloma virus (HPV), hepatitis A and meningococcal vaccines. The ProVac models and tools have been used in partner collaborations to support countries in other regions. The open access tools have been downloaded multiple times by partners, academics and other researchers. Provac has also contributed to the strengthening of National Immunization technical advisory groups through direct support.


Audience of the ProVac training modules


The primary audience is national multi-disciplinary teams of Ministries of Health personnel. Secondary audiences are national, regional and international academics, donors and partner institutions.


Objectives of the ProVac training modules


The main goal of the ProVac training modules is to enable the general audience of the ProVac e-toolkit to become acquainted with economic evaluations, and for country teams aiming at using the ProVac tools to support national-level evidence-based decisions around immunization, to become proficient in the use of the ProVac tools. Thus, the training courses have been developed with these two audiences in mind, with the initial modules remaining more general and covering basic concepts and a broad description of the tools, and becoming progressively more specific and focuses as the user advances to later modules.


ProVac Training modules: Overview of existing tools


UNIVAC model

UNIVAC is a single universal vaccine impact and cost-effectiveness decision support model with a standardized, accessible Excel-based interface and a familiar set of input steps and outputs. Input estimates of age-specific disease burden, age/dose specific vaccine coverage and effectiveness allow for a simple evaluation of direct vaccination impact on health outcomes. Additional input parameters can be included to evaluate indirect effects, which may be important for the evaluation of several vaccines. The tool features automated calculations, options for sensitivity analysis and automatically generated results charts and figures.


COSTVAC is an Excel-based toolkit that provides structured guidance on how to estimate the cost of routine immunization from a sample of health facilities and administrative levels of the health system. This toolkit provides guidance on sampling, survey instrument development and administration, and calculations. It was developed to help countries more precisely document the shared resource use between the immunization program and other health service provision. Users can define the perspective and scope of the analysis.


PAHO ProVac e-toolkit was developed with extensive collaboration and input from the ProVac advisory consultant team and network of Centers of Excellence (LSHTM, Harvard Center for Health Decision Science, Rutgers University, Universidade Federal de Goias, Instituto de Efectividad Clinica y Sanitaria, Universidade de São Paulo, Universidade Estatal do Rio de Janiero, Universidad de Cartagena, Universidad Nacional de Colombia). User feedback from country decision makers and public health practitioners in the field of immunization across Latin America and the Caribbean has been a critical input into tool development and refinement over the past ten years. Additionally, partners involved in the ProVac Internatinonal Working Group and other collaborations, including AMP, CDC, Gavi, Path and Sabin, have provided immense support in modifying tool for application in non-PAHO Regions. The ProVac Initiative and the e-toolkit have received kind financial support from the Bill and Melinda Gates Foundation and from the US-CDC.

For more information, contact Nathalie El Omeiri, Evidence-based Policy Specialist, Pan American Health Organization/World Health Organization, elomeirin@paho.org