Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA.
Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY 10027, USA.
Vaccine. 2021 Jul 22;39(32):4437-4449. doi: 10.1016/j.vaccine.2021.05.075. Epub 2021 Jul 1.
Understanding the costs to increase vaccination demand among under-vaccinated populations, as well as costs incurred by beneficiaries and caregivers for reaching vaccination sites, is essential to improving vaccination coverage. However, there have not been systematic analyses documenting such costs for beneficiaries and caregivers seeking vaccination.
We searched PubMed, Scopus, and the Immunization Delivery Cost Catalogue (IDCC) in 2019 for the costs for beneficiaries and caregivers to 1) seek and know how to access vaccination (i.e., costs to immunization programs for social mobilization and interventions to increase vaccination demand), 2) take time off from work, chores, or school for vaccination (i.e., productivity costs), and 3) travel to vaccination sites. We assessed if these costs were specific to populations that faced other non-cost barriers, based on a framework for defining hard-to-reach and hard-to-vaccinate populations for vaccination.
We found 57 studies describing information, education, and communication (IEC) costs, social mobilization costs, and the costs of interventions to increase vaccination demand, with mean costs per dose at $0.41 (standard deviation (SD) $0.83), $18.86 (SD $50.65) and $28.23 (SD $76.09) in low-, middle-, and high-income countries, respectively. Five studies described productivity losses incurred by beneficiaries and caregivers seeking vaccination ($38.33 per person; SD $14.72; n = 3). We identified six studies on travel costs incurred by beneficiaries and caregivers attending vaccination sites ($11.25 per person; SD $9.54; n = 4). Two studies reported social mobilization costs per dose specific to hard-to-reach populations, which were 2-3.5 times higher than costs for the general population. Eight studies described barriers to vaccination among hard-to-reach populations.
Social mobilization/IEC costs are well-characterized, but evidence is limited on costs incurred by beneficiaries and caregivers getting to vaccination sites. Understanding the potential incremental costs for populations facing barriers to reach vaccination sites is essential to improving vaccine program financing and planning.
了解增加未接种疫苗人群疫苗接种需求的成本，以及受益人及其照顾者为到达疫苗接种点所产生的成本，对于提高疫苗接种覆盖率至关重要。然而，目前还没有系统的分析来记录受益人及其照顾者在寻求疫苗接种时的这些成本。
我们于 2019 年在 PubMed、Scopus 和免疫接种交付成本目录（IDCC）中搜索了受益人及其照顾者为 1）寻求并了解如何获得疫苗接种（即免疫规划的社会动员和增加疫苗接种需求的干预措施的成本），2）因疫苗接种而请假、家务或学业（即生产力成本），以及 3）前往疫苗接种点所产生的成本的信息。我们根据为疫苗接种确定难以接触和难以接种人群的框架，评估这些成本是否特定于面临其他非成本障碍的人群。
我们发现了 57 项研究，描述了信息、教育和沟通（IEC）成本、社会动员成本以及增加疫苗接种需求的干预措施的成本，低收入、中等收入和高收入国家每剂的平均成本分别为 0.41 美元（标准差 0.83）、18.86 美元（标准差 50.65）和 28.23 美元（标准差 76.09）。五项研究描述了受益人及其照顾者在寻求疫苗接种时产生的生产力损失（每人 38.33 美元；标准差 14.72；n=3）。我们确定了六项关于受益人及其照顾者前往疫苗接种点所产生的旅行成本的研究（每人 11.25 美元；标准差 9.54；n=4）。两项研究报告了针对难以接触人群的每剂社会动员成本，这比一般人群的成本高 2-3.5 倍。八项研究描述了难以接触人群中存在的疫苗接种障碍。
社会动员/IEC 成本已得到充分描述，但有关受益人及其照顾者到达疫苗接种点所产生的成本的证据有限。了解面临到达疫苗接种点障碍的人群的潜在增量成本对于改善疫苗规划供资和规划至关重要。
