As part of the Immunization Costing Action Network, ThinkWell and the Hanoi University of Public Health conducted a study to provide evidence on the costs and budgetary impact of the potential replacement of the tetanus-toxoid (TT) vaccine with the tetanus-diphtheria (Td) vaccine in Vietnam, considering different possible delivery strategies.
The study used an activity-based ingredients costing approach to estimate the 2017 program costs of providing TT vaccination to girls aged 15–16 years and conducting Td campaigns in outbreak areas. The team also performed a budget impact analysis for 2018–2025 using the cost per dose estimates based on the current delivery of these vaccines. The analysis assumed a complete cessation of TT vaccination of girls aged 15–16 years and a transition period where Td outbreak control campaigns would still occur. The Td vaccine was assumed to be provided to children aged seven years using either facility- or school-based delivery or combined facility- and school-based delivery.
The findings showed that the delivery cost per dose for current TT vaccination for girls aged 15–16 years was US$1.49 for school-based delivery, US$1.76 for facility-based delivery, and US$3.86 for delivery via outreach. Td vaccination through campaigns was estimated to cost US$3.56/dose. During 2018–2025, replacing the TT vaccine for girls aged 15–16 years with the Td vaccine for children aged seven years is estimated to save US$4.61 million in immunization delivery costs if a school-based delivery strategy is used or US$1.04 million if facility-based delivery is used.
Compared to the current plan, delivery of routine Td vaccination via a school-based strategy was the most cost saving. These results were used in late 2019 to support the delivery of Td vaccination using a school-based delivery strategy for children aged seven years in 30 northern provinces in Vietnam.
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