Immunization campaigns during the Covid-19 pandemic: A rapid analysis of the additional operational cost

08 July 2020

The below content is presented as a poster at the Virtual COVID-19 Conference on July 10-11, 2020. It was prepared by Christina Banks and Laura Boonstoppel. This work was supported by the Bill & Melinda Gates Foundation.


  • Most mass immunization campaigns have been suspended due to the COVID-19 pandemic
  • Precautionary measures will need to be implemented to ensure the safety of health workers and the community

This analysis estimates the potential additional operational cost of an immunization campaign held during the COVID-19 pandemic



  • Data from 10 studies on the cost of conducting campaigns in low- and middle-income countries were used
  • Four scenarios were developed based on a review of WHO guidance on delivering services during COVID-19 and data on campaigns conducted in similar settings:
  1. Providing personal protective equipment (PPE) for health workers and infection prevention and control (IPC) measures at sites
  2. Extra staff and supplies to support physical distancing and screening
  3. Additional per diems associated with changes in delivery strategies that reduce daily coverage levels
  4. Increases in certain operational cost components (such as additional social mobilization and transport)
  • Within each scenario, varying intensities of measures were identified
  • The incremental cost per dose and percentage increase in cost per dose due to the additional measures were calculated


The results indicate that adding basic PPE and IPC measures on their own will likely not drive up the costs of a campaign significantly, but that having to add staff, pay staff additional per diems to implement the work over a longer period of time or additional cost from, for example, intensified social mobilization efforts could potentially have a large impact on the operational cost of a campaign.

immunization campaign costing


A better understanding of the cost implications of preventing a drop in immunization coverage while ensuring the safety of health workers and beneficiaries will help countries make informed allocation decisions and mobilize funding for a comprehensive COVID-19 response.