Following disruption to immunization services during the COVID-19 pandemic, Health Systems Insight (formerly ThinkWell Institute) responded with analyses estimating the additional operational cost of implementing campaigns and conducting routine outreach services during the pandemic while incorporating a range of protective measures, and collaborated with Harvard T.H. Chan School of Public Health on an analysis for routine fixed site delivery. Read the publication on this work in Vaccine.
Further to this, the team conducted an analysis estimating the potential additional operational cost of a house-to-house oral polio vaccine (OPV) supplemental immunization activity (SIA) held during the COVID-19 pandemic.
The COVID-19 pandemic has been disrupting immunization services that are critical to the prevention of morbidity and mortality from vaccine-preventable diseases in many low- and middle-income countries (LMICs) around the world. Many LMICs have experienced drops in vaccination coverage due to interruptions and suspensions in the provision of essential routine services as well as decreases in the demand for those services due to concerns about contracting COVID-19 when interacting with the health care system.
In order to maintain or restore immunization coverage levels while minimizing COVID-19 transmission and ensuring the safety of health workers and the community, modifications in the way vaccines are delivered are required. These modifications may change the cost of conducting immunization services, and may require additional budgetary support and planning to implement. World Health Organization (WHO) guidance advises countries to explore innovative methods for vaccine delivery to optimize service delivery while allowing for physical distance and minimizing the risks of COVID-19 transmission.
In collaboration with the Harvard T.H. Chan School of Public Health, Health Systems Insight (formerly ThinkWell Institute) estimated the additional resource requirements for immunization campaigns and routine immunization delivered at facilities and through outreach in the context of the COVID-19 pandemic.
Further to this, the team conducted an analysis estimating the potential additional operational cost of a house-to-house oral polio vaccine (OPV) supplemental immunization activity (SIA) held during the COVID-19 pandemic.
The findings showed that implementing a range of measures to protect health workers and communities from COVID-19 transmission could result in a per-facility start-up cost of $466–799 for routine fixed-site delivery and $12–220 for routine outreach delivery, and $12–108 per immunization campaign site. A recurrent monthly cost of $137–1,024 for fixed-site delivery and $152–848 for outreach delivery per facility could be incurred, and a $0.32–0.85 increase in the cost per dose during campaigns.
This analysis estimates the potential additional operational cost of a house-to-house oral polio vaccine
(OPV) supplemental immunization activity (SIA) held during the COVID-19 pandemic. The results of this analysis suggest that the operational cost of house-to-house oral polio vaccine supplemental immunization activity could increase by up to 87% when measures such as hand hygiene and personal protective equipment are implemented; up to 58% when accounting for additional per diems and incentives due to increased campaign length and; up to 77% when considering increases in other operational cost components due to COVID-related disruption.
