There is a growing consensus that the COVID-19 pandemic is disrupting immunization services that are critical to the prevention of morbidity and mortality from vaccine-preventable diseases in many low- and middle-income countries. In these settings, the health benefits associated with routine childhood immunization greatly outweigh the COVID-19 related health risks. However, the conduct of routine vaccine delivery will need to be modified in order to be successfully implemented in the pandemic context. The brief by the EPIC team at Harvard, with support from the Bill & Melinda Gates Foundation, estimates the resource requirements associated with modifications to routine immunization services at fixed sites such as primary health clinics.
Harvard EPIC estimated the additional per-facility costs, accounting for several changes to vaccine delivery, to enable the routine immunization program to be carried out in the context of COVID-19. The team reports on costs per facility based on assumptions about the number of health care workers, immunization sessions, and patients per session. They partitioned facilities into low-, medium-, and high-volume facilities., reporting the costs as either one-time costs or monthly costs that are assumed to recur as long as COVID-19 risk is present. Each cost category is presented as the incremental financial outlays required for the relevant adjustments.
This rapid analysis aims to illustrate a range of potential cost implications and provide general guidance for EPI managers developing COVID-19 mitigation plans and preparing for mobilization of additional resources. Setting-specific analysis will be necessary to determine the appropriate COVID-related modifications needed to maintain routine immunization services safely and to precisely estimate the startup and monthly recurring resource requirements for those modifications.
Recommended citation: Portnoy A and Resch S. 2020. Estimating the additional cost for maintaining facility-based Routine Immunization programs in the context of COVID-19. Boston: Harvard T.H. Chan School of Public Health
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