Abstract
Background
Beyond vaccine procurement, there are considerable costs associated with vaccine delivery, known as delivery or operational costs. Particularly for the main cost drivers of human resources, cold chain, social mobilization, and vaccination services delivered outside health facilities, delivery cost estimates are essential for optimal planning and budgeting at country level, and for fundraising and advocacy at global level. Until now, the only source of cost estimates for COVID-19 vaccine delivery was the mathematical model (paper 2), based on childhood immunization estimates.
Research question or aim
The aim was to evaluate the costs of COVID-19 vaccine delivery in Botswana from its start in early 2021 until early 2022.
Study objectives were:
To estimate the total costs of COVID-19 vaccine delivery during the first year of delivery
To estimate the total costs of COVID-19 vaccine procurement during the first year of the programme
To estimate the costs per dose delivered
Methods
We tested new approaches to immunization cost data collection, including collecting data from national and regional level instead of facilities, top-down methods and focusing primarily on the main cost drivers. In this presentation we will report cost per dose findings and compare them with the modelled estimates and with costs of routine immunization.
Key results
The findings suggest that rolling out a new vaccine to an entire population in the middle of a global pandemic is much costlier than previous vaccination efforts in Botswana or elsewhere, and costlier
than modelled estimates predicted. We will offer explanations for why the expected large expenditures for cold chain expansion and social mobilization and transport did not happen, and how human resources for health gaps were filled. We will also provide feedback on the new approaches to data collection and make methodological recommendations for improving future immunization cost data collection.
Implications for policy and practice
Previous research has shown that cost data are generally insufficiently used by policy makers. We will open up for discussion on how the results can best be used in Botswana.