Immunization Delivery Cost Catalogue update: The state of the evidence on the costs of delivering immunization in low- and middle-income countries

ThinkWell is pleased to present an updated version of the Immunization Delivery Cost Catalogue, or IDCC, the most comprehensive, current, and standardized database on the cost of delivering vaccines in low- and middle-income countries. Based on a systematic review of over 22,000 publications, the updated IDCC presents 1,156 unique unit costs from 119 publications, in 2022 US$. First developed in 2017 by ThinkWell under the Immunization Cost Action Network (ICAN) project, the IDCC was previously updated in 2018, 2019. This update adds 607 unit cost from 62 studies—including from 12 countries previously not represented in the IDCC.

The analysis brief summarizes the state of the evidence, provides ranges for delivery cost per dose, and highlights remaining evidence gaps. The brief illustrates that:

• The median financial cost per dose of delivering vaccines is $0.52 for SIAs and $1.34 for routine.
• Across delivery strategies, the median cost was highest for outreach or mobile delivery ($3.37) and lowest for facility-based delivery ($1.65)
• The median cost per dose for delivering vaccines to different target populations ranged from $0.63 for delivery to infants and children up to 15yo, to $2.85 for delivering to C19 priority populations.

More evidence is still needed:

• On the cost of reaching zero dose children and other specific target population groups such as out-of-school girls and the elderly.
• On cost of delivering vaccines through different delivery strategies.
• On the cost of delivering vaccines through supplementary immunization activities (SIAs).
• For the 28 Gavi-eligible countries and 86 low- and middle-income countries for which delivery cost evidence is currently missing.

The IDCC is accompanied by its Methodology note and the Codebook and Definitions document. Products related to past IDCC updates can be found here.