UPDATE: The additional operational cost of conducting immunization campaigns during the Covid-19 pandemic

09 June 2020

Note: This is an update of a post that was published on the 15th of May. This update reflects newly published guidance from WHO on the implementation of campaigns in the context of COVID-19.

Many immunization campaigns have been suspended to prevent increased COVID-19 transmission, but some campaigns will nevertheless need to go ahead, with additional precautionary measures in place to ensure the safety of health workers and the community.

With support from the Bill & Melinda Gates Foundation, ThinkWell has estimated the added cost per dose of several potential precautionary measures: personal protective equipment (PPE) for vaccination teams, additional infection prevention and control (IPC) measures at immunization sites, extra staff and supplies to ensure physical distancing and triaging at campaign sites, additional per diems due to potential changes in delivery strategies, and estimates of an increase of other operational cost components (such as additional social mobilization and training). The analysis uses data from 10 studies on the cost of conducting an immunization campaign to model each scenario at a low, medium and high intensity level, as well as the combined effect on the cost per dose.

The results of this analysis of the additional delivery cost of conducting campaigns during COVID-19 show that:

• The cost per dose could increase by 5% when placing hand washing stations at campaign sites and 9-20% when adding PPE for health workers.
• Adding crowd controllers to vaccination teams to manage physical distancing and screening at campaign sites could imply a 10-26% increase in the operational cost per dose.
• Per diems associated with a longer campaign duration could result in a 8-32% increase.
• An increase in other operational aspects of the campaign, such as social mobilization and transport, could increase the operational cost of a campaign by 10-40%.
• All protective measures and operational changes combined could increase the operational cost of a campaign by 49% in the low scenario up to 154% in the high scenario.

This rapid analysis is meant to illustrate a range of potential cost implications to provide general guidance for the direction of policies and potential cost expectations that would require the mobilization of additional resources.

To read the full report, click here.

Follow-up analyses conducted by ThinkWell and the Harvard T.H. Chan School of Public Health will assess the cost implications for routine and routine outreach immunization service delivery.