Mass hiring drove up the cost of delivering COVID-19 vaccines in the Philippines found in new study

Rapidly delivering COVID-19 vaccines in the Philippines presented challenges for the government in terms of the scale of the vaccination program required and the new target populations which needed to be reached, while the cost of delivering these vaccines was uncertain. To support the government of the Philippines and address this knowledge gap, ThinkWell and the Ateneo School of Medicine and Public Health conducted a retrospective, bottom-up study on the cost of COVID-19 vaccine delivery through the mass campaigns (National Vaccination Days) and through routine-style delivery at sites managed by city health offices, temporary mall sites, rural health units and through private providers. This was complemented by a qualitative assessment to identify operational challenges encountered during the implementation of the program. You can find the full study report and key findings below:

KEY FINDINGS

• The economic cost of delivering vaccines during the first National Vaccination Day campaign in November-December 2021, during which over 10 million people were vaccinated, varied from $1.75 at temporary mall sites to $2.59 at rural health units.

• During a period of routine style delivery from May-July 2022, by when delivery volumes had dropped substantially and many temporary sites had closed, the economic delivery unit cost varied from $3.28 at private providers to $12.05 at rural health units.

• Incremental financial expenditures accounted for the majority of the cost at most vaccination sites, particularly during the campaign, due to additional hiring of health workers. This was less often the case at rural health units which were more reliant on their existing staff and redeployed health workers.

• The unit costs, particularly financial, found by this study were generally higher than the estimates for COVID-19 vaccine delivery in other low- and middle-income countries. The financial cost per dose during a mass vaccination delivery period was estimated at $0.43 in Mozambique and $0.56 per dose in Vietnam. The cost of routine-style delivery of COVID-19 vaccines ranged from $0.67 per dose in Côte d’Ivoire, to $0.96 in Mozambique and $2.08 in Vietnam, during the initial low-volume periods.

 KEY TAKEAWAYS

• The COVID-19 vaccination program in the Philippines was successful in rapidly reaching high coverage levels, and one distinctive success factor was its ability to rapidly mass hire additional health workers.

• Financial delivery costs were high compared to other low- and middle-income countries, particularly due to mass hiring and refreshments provided to health workers.

• The COVID-19 vaccination program leveraged many different delivery strategies, and our study found high variation in the cost profiles and delivery rates across different vaccination sites, as well as between similar types of vaccination sites.

• Temporary vaccination sites run by city health offices, including temporary mall sites, were very effective during the early, large-volume National Vaccination Days, and although less so once delivery volumes dropped and sites reported idle time, the cost per dose delivered remained far below that of smaller rural health units.

This study is part of a multi-country project that utilizes standardized methods to generate cost evidence on the delivery of C19 vaccines in low- and middle-income countries. The project is led by ThinkWell, and supported by the Bill & Melinda Gates Foundation, and covers studies in Côte d’Ivoire, the Democratic Republic of Congo, Mozambique, Uganda, Vietnam, Bangladesh, and the Philippines.