The cost of introducing HPV vaccination into Nigeria’s Expanded Program on Immunization: Lessons from two states

This peer-reviewed article presents findinds from a financial cost analysis of introducing the quadrivalent human papillomavirus (HPV) vaccine into Nigeria’s Expanded Program on Immunization (EPI), focusing on Bayelsa and Taraba states. Using an ingredients-based costing approach from the provider perspective, the authors combined quantitative expenditure data (based on the 2023 Vaccine Introduction Grant and program reports) with qualitative key informant interviews to estimate the financial and approximate economic costs of the HPV vaccine introduction campaign and its early routinization.

Key findings

• The total financial cost per fully vaccinated girl was $5.76 in Bayelsa and $5.75 in Taraba.
• The vaccine product accounted for approximately 82% of total costs ($4.73 per girl), making it the primary cost driver.
• Operational costs represented about 18% of total costs, with logistics and transportation as the largest operational component.
• Transportation and logistics costs were particularly significant in hard-to-reach settings, including riverine LGAs in Bayelsa that required speedboats.
• Advocacy, communication, and social mobilization (ACSM) cost $0.17 per girl and contributed to achieving relatively high coverage in both states.
• Coverage reached 74% in Bayelsa and 78% in Taraba during the five-day campaign, compared to a 64% national average in phase 1 states.
• An estimated additional $0.73 per girl represented economic costs related mainly to existing personnel time (approximately 12.7% above financial costs).
• The combination of an initial intensive campaign followed by integration into routine immunization proved effective for rapid scale-up.

Thumbnail image credit: Hadiza Hussayn Jibril