This peer-reviewed article, published in Vaccine by reserachers at PATH and the Ethiopia Ministry of Health, examines the delivery costs and operational context of administering a single-dose human papillomavirus (HPV) vaccination regimen to a multi-age cohort (MAC) of adolescent girls aged 9–14 years in Ethiopia. The paper reports findings from a cross-sectional retrospective costing study conducted after Ethiopia’s national MAC HPV vaccination campaign in late 2024. The analysis combines ingredients-based micro-costing methods with an embedded operations research component, drawing on primary data collected at 82 health facilities across four regions (Addis Ababa, Afar, Amhara, and Somali), as well as at subnational and national administrative levels, and estimates both financial and economic delivery costs from a health-system perspective.
Key findings
Most health facilities relied on school-based delivery (90%), while community outreach was also widely used (73%), reflecting efforts to reach out-of-school adolescents, including those in fragile and conflict-affected settings.
Facilities delivered an average of 910 HPV vaccine doses per facility during the campaign, typically over a five-day implementation period.
Opportunity costs accounted for the majority of delivery costs at the health-facility level (79%), while financial costs represented a larger share at administrative levels (at least 52%).
Aggregated across all levels of the health system, delivery costs were estimated at US$0.66 per dose (financial costs) and US$1.67 per dose (economic costs) for the single-dose regimen.
The single-dose MAC campaign was associated with substantially lower delivery costs compared with previously reported estimates for two-dose HPV vaccination in Ethiopia.
Thumbnail image credit: Gavi
Any organization or individual working in the field of immunization economics can submit findings, opportunities, calls to action, or other relevant work below to be shared with our community.