Cost of the typhoid conjugate vaccine introduction through an integrated campaign and follow-on routine immunization in Malawi
Malawi introduced typhoid conjugate vaccine (TCV) in 2023 through an integrated campaign delivering TCV alongside other vaccines and interventions (measles rubella vaccine (MRV), bivalent oral polio vaccine (OPV), and vitamin A Supplementation). The campaign sought to reach all children 9 months to...
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Elsevier
2024-12-01
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| Series: | Vaccine: X |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590136224001566 |
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| author | Frédéric Debellut George Bello Mike Chisema Rouden Mkisi Moses Kamzati Clint Pecenka Emmanuel Mugisha |
| author_facet | Frédéric Debellut George Bello Mike Chisema Rouden Mkisi Moses Kamzati Clint Pecenka Emmanuel Mugisha |
| author_sort | Frédéric Debellut |
| collection | DOAJ |
| description | Malawi introduced typhoid conjugate vaccine (TCV) in 2023 through an integrated campaign delivering TCV alongside other vaccines and interventions (measles rubella vaccine (MRV), bivalent oral polio vaccine (OPV), and vitamin A Supplementation). The campaign sought to reach all children 9 months to younger than 14 years, representing more than 9 million individuals, and about half the country’s population. Following the campaign, TCV was incorporated into the routine immunization program for 9-month-old infants. We conducted a micro-costing study at 50 randomly selected health facilities, 10 districts, and at national level to retrospectively assess the financial and economic cost of the integrated campaign, as well as prospectively estimate the cost of delivering TCV in the routine immunization system. The financial and economic costs per dose for all interventions delivered in the campaign were $0.49 ($0.42;$0.57) and $0.84 ($0.67;$1.02), respectively. The main activities and cost types varied; human resources represented the main resource at health facility level, and per diem at district and national levels. The financial and economic cost to routinely deliver a dose of TCV were $0.44 ($0.17;$0.87), and $2.37 ($1.39;$3.53), respectively, with human resources as the main resource used by the routine program at all levels.The cost per dose delivered in the integrated campaign in Malawi was comparable with other integrated campaigns and was lower than the reported cost to deliver TCV in single antigen campaigns in India and Zimbabwe. Integrated campaigns may represent an opportunity to introduce new vaccines such as TCV to lower the cost per dose delivered. Attention should be given to challenges coming with integration, such as the burden for healthcare workers.Evidence produced by this study can be used in Malawi to inform financial sustainability of the TCV program and should inform decisions and strategies for implementation by other countries. |
| format | Article |
| id | doaj-art-da193e296ab94562a7eebc6737a89bfc |
| institution | DOAJ |
| issn | 2590-1362 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Vaccine: X |
| spelling | doaj-art-da193e296ab94562a7eebc6737a89bfc2025-08-20T03:13:53ZengElsevierVaccine: X2590-13622024-12-012110058310.1016/j.jvacx.2024.100583Cost of the typhoid conjugate vaccine introduction through an integrated campaign and follow-on routine immunization in MalawiFrédéric Debellut0George Bello1Mike Chisema2Rouden Mkisi3Moses Kamzati4Clint Pecenka5Emmanuel Mugisha6Center for Vaccine Innovation and Access, PATH, Geneva, Switzerland; Corresponding author at: Rue de Varembé 7, Geneva, Switzerland.Epidemiology Unit, Ministry of Health, Lilongwe, MalawiExpanded Programme on Immunization, Ministry of Health, Lilongwe, MalawiCenter for Vaccine Innovation and Access, PATH, Lilongwe, MalawiThe Mitchel group, USAID Malawi Learn to Perform, Lilongwe, MalawiCenter for Vaccine Innovation and Access, PATH, Seattle, WA, USACenter for Vaccine Innovation and Access, PATH, Kampala, UgandaMalawi introduced typhoid conjugate vaccine (TCV) in 2023 through an integrated campaign delivering TCV alongside other vaccines and interventions (measles rubella vaccine (MRV), bivalent oral polio vaccine (OPV), and vitamin A Supplementation). The campaign sought to reach all children 9 months to younger than 14 years, representing more than 9 million individuals, and about half the country’s population. Following the campaign, TCV was incorporated into the routine immunization program for 9-month-old infants. We conducted a micro-costing study at 50 randomly selected health facilities, 10 districts, and at national level to retrospectively assess the financial and economic cost of the integrated campaign, as well as prospectively estimate the cost of delivering TCV in the routine immunization system. The financial and economic costs per dose for all interventions delivered in the campaign were $0.49 ($0.42;$0.57) and $0.84 ($0.67;$1.02), respectively. The main activities and cost types varied; human resources represented the main resource at health facility level, and per diem at district and national levels. The financial and economic cost to routinely deliver a dose of TCV were $0.44 ($0.17;$0.87), and $2.37 ($1.39;$3.53), respectively, with human resources as the main resource used by the routine program at all levels.The cost per dose delivered in the integrated campaign in Malawi was comparable with other integrated campaigns and was lower than the reported cost to deliver TCV in single antigen campaigns in India and Zimbabwe. Integrated campaigns may represent an opportunity to introduce new vaccines such as TCV to lower the cost per dose delivered. Attention should be given to challenges coming with integration, such as the burden for healthcare workers.Evidence produced by this study can be used in Malawi to inform financial sustainability of the TCV program and should inform decisions and strategies for implementation by other countries.http://www.sciencedirect.com/science/article/pii/S2590136224001566Immunization delivery costIntegrated campaignImmunization campaignTyphoid conjugate vaccineMalawi |
| spellingShingle | Frédéric Debellut George Bello Mike Chisema Rouden Mkisi Moses Kamzati Clint Pecenka Emmanuel Mugisha Cost of the typhoid conjugate vaccine introduction through an integrated campaign and follow-on routine immunization in Malawi Vaccine: X Immunization delivery cost Integrated campaign Immunization campaign Typhoid conjugate vaccine Malawi |
| title | Cost of the typhoid conjugate vaccine introduction through an integrated campaign and follow-on routine immunization in Malawi |
| title_full | Cost of the typhoid conjugate vaccine introduction through an integrated campaign and follow-on routine immunization in Malawi |
| title_fullStr | Cost of the typhoid conjugate vaccine introduction through an integrated campaign and follow-on routine immunization in Malawi |
| title_full_unstemmed | Cost of the typhoid conjugate vaccine introduction through an integrated campaign and follow-on routine immunization in Malawi |
| title_short | Cost of the typhoid conjugate vaccine introduction through an integrated campaign and follow-on routine immunization in Malawi |
| title_sort | cost of the typhoid conjugate vaccine introduction through an integrated campaign and follow on routine immunization in malawi |
| topic | Immunization delivery cost Integrated campaign Immunization campaign Typhoid conjugate vaccine Malawi |
| url | http://www.sciencedirect.com/science/article/pii/S2590136224001566 |
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