How much does it cost to deliver COVID vaccine in low- and middle-income countries? $1.66 per dose
11 February 2021
In April 2020, COVAX was launched to help ensure that “people in all corners of the world will get access to COVID-19 vaccines once they are available, regardless of their wealth.”
With around 190 participating countries, the COVAX Facility is a global risk-sharing mechanism for pooled procurement and equitable distribution of COVID-19 vaccines. Through the COVAX Advance Market Commitment (AMC), 92 low- and middle-income countries will be able to access subsidized COVID-19 vaccines. This amounts to approximately 1,319 million vaccine doses and will cover about 20% of the countries’ total population.
ThinkWell is a part of a multi-organizational costing working group that estimated the cost of delivering COVID-19 vaccines in these 92 AMC countries.
The model estimated the cost of delivering two doses to health workers through fixed site delivery and to elderly populations through outreach. The model costed incremental financial costs only, assuming that countries will leverage existing health systems (e.g., using existing cold chain equipment).
The total financial delivery costs—including country, regional, and global level costs—amounts to US$2.018 billion, equivalent to US$1.66 per dose supplied and US$3.70 per person vaccinated with two doses (after accounting for vaccine wastage).
Country-level delivery costs amounts to US$1.41 per dose. This includes per diems for health workers, transport, cold chain equipment and running costs, social mobilization, planning, training, personal protective equipment, waste management, pharmacovigilance, and vaccination certificates. It excludes health worker salaries. The cost of implementing an ultra-cold chain was not included, as vaccines that require ultra-cold chain storage will only comprise a small proportion of the overall COVAX facility portfolio of vaccines.
Technical assistance at global, regional, and country level is estimated at US$0.16 per dose delivered. The estimates also include US$77.9 million for five innovations that are being accelerated to advance COVID-19 vaccine delivery: smart vaccination certificates, traceability solution, real-time monitoring, digital micro-planning, and digital tools for safety monitoring. Additionally, the cost of pharmacovigilance and post-introduction evaluations at global and regional level are estimated at US$20.6 million.
COVID-19 vaccine delivery will require adapted delivery methods to reach new target populations. To generate these global level estimates, the team developed scenarios around data from existing immunization studies, including previous Immunization Costing Action Network (ICAN) studies in Indonesia, Tanzania, Sierra Leone, and India, and analysis on the cost of delivering campaigns and outreach during the pandemic. They also relied heavily on unit costs from the Immunization Delivery Cost Catalogue (IDCC), the most comprehensive, current, and standardized global evidence on the cost of delivering vaccines, which ThinkWell built with support from the Bill & Melinda Gates Foundation.
COVAX stakeholders use these cost estimates for planning, budgeting, and fundraising for COVID-19 vaccine delivery at the global level. At the country level, governments and partners can utilize the COVID-19 vaccine introduction and deployment costing tool (CVIC), which has been developed for detailed planning and budgeting of COVID-19 vaccine delivery strategies.
To further explore the costs of delivering COVID-19 vaccines in 92 AMC countries, you can read the full report or have a look at the summary slide deck. More information about the research is also on immunizationeconomics.org here.
ThinkWell is continuing to support countries to cost their COVID-19 vaccine roll out strategies.