U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.
Washington State University (WSU) Global Health Kenya, Nairobi, Kenya.
Vaccine. 2024 Oct 24;42 Suppl 4(Suppl 4):125519. doi: 10.1016/j.vaccine.2023.12.029. Epub 2023 Dec 27.
During November 2019-October 2021, a pediatric influenza vaccination demonstration project was conducted in four sub-counties in Kenya. The demonstration piloted two different delivery strategies: year-round vaccination and a four-month vaccination campaign. Our objective was to compare the costs of both delivery strategies.
Cost data were collected using standardized questionnaires and extracted from government and project accounting records. We reported total costs and costs per vaccine dose administered by delivery strategy from the Kenyan government perspective in 2021 US$. Costs were separated into financial costs (monetary expenditures) and economic costs (financial costs plus the value of existing resources). We also separated costs by administrative level (national, regional, county, sub-county, and health facility) and program activity (advocacy and social mobilization; training; distribution, storage, and waste management; service delivery; monitoring; and supervision).
The total estimated cost of the pediatric influenza demonstration project was US$ 225,269 (financial) and US$ 326,691 (economic) for the year-round delivery strategy (30,397 vaccine doses administered), compared with US$ 214,753 (financial) and US$ 242,385 (economic) for the campaign strategy (25,404 doses administered). Vaccine purchase represented the largest proportion of costs for both strategies. Excluding vaccine purchase, the cost per dose administered was US$ 1.58 (financial) and US$ 5.84 (economic) for the year-round strategy and US$ 2.89 (financial) and US$ 4.56 (economic) for the campaign strategy.
The financial cost per dose was 83% higher for the campaign strategy than the year-round strategy due to larger expenditures for advocacy and social mobilization, training, and hiring of surge staff for service delivery. However, the economic cost per dose was more comparable for both strategies (year-round 22% higher than campaign), balanced by higher costs of operating equipment and monitoring activities for the year-round strategy. These delivery cost data provide real-world evidence to inform pediatric influenza vaccine introduction in Kenya.
2019 年 11 月至 2021 年 10 月，在肯尼亚的四个分区开展了儿科流感疫苗示范项目。该示范项目试点了两种不同的交付策略：全年接种和为期四个月的疫苗接种运动。我们的目标是比较这两种交付策略的成本。
使用标准化问卷收集成本数据，并从政府和项目会计记录中提取数据。我们从肯尼亚政府的角度报告了 2021 年以美元计价的两种交付策略的总费用和每剂疫苗的费用，分别为财务成本（货币支出）和经济成本（财务成本加上现有资源的价值）。我们还按行政级别（国家、地区、县、分区和卫生机构）和规划活动（宣传和社会动员；培训；分发、储存和废物管理；服务提供；监测和监督）对成本进行了分类。
全年交付策略（接种 30397 剂疫苗）的儿科流感示范项目总成本估计为 225269 美元（财务）和 326691 美元（经济），而运动策略（接种 25404 剂疫苗）的总成本估计为 214753 美元（财务）和 242385 美元（经济）。疫苗采购是两种策略成本的最大组成部分。不包括疫苗采购，全年策略的每剂疫苗接种成本为 1.58 美元（财务）和 5.84 美元（经济），运动策略为 2.89 美元（财务）和 4.56 美元（经济）。
由于运动策略在宣传和社会动员、培训以及为服务提供雇用临时工作人员方面的支出较大，因此其每剂疫苗的财务成本比全年策略高 83%。然而，两种策略的每剂疫苗的经济成本更为接近（全年策略高 22%），这是由于全年策略的设备运行和监测活动成本较高所致。这些交付成本数据为肯尼亚引入儿科流感疫苗提供了真实世界的证据。
