Costs of delivering human papillomavirus vaccination using a one- or two-dose strategy in Tanzania

Amber Hsiao, Verena Struckmann, Victor Stephani, Devis Mmbando, John Changalucha, Kathy Baisley, Ann Levin, Winthrop Morgan, Raymond Hutubessy, Deborah Watson-Jones, Hilary Whitworth, Wilm Quentin, Amber Hsiao, Verena Struckmann, Victor Stephani, Devis Mmbando, John Changalucha, Kathy Baisley, Ann Levin, Winthrop Morgan, Raymond Hutubessy, Deborah Watson-Jones, Hilary Whitworth, Wilm Quentin

Abstract

Objective: As part of the Dose Reduction Immunobridging and Safety Study of Two HPV Vaccines in Tanzanian Girls (DoRIS; NCT02834637), the current study is one of the first to evaluate the financial and economic costs of the national rollout of an HPV vaccination program in school-aged girls in sub-Saharan Africa and the potential costs associated with a single dose HPV vaccine program, given recent evidence suggesting that a single dose may be as efficacious as a two-dose regimen.

Methods: The World Health Organization's (WHO) Cervical Cancer Prevention and Control Costing (C4P) micro-costing tool was used to estimate the total financial and economic costs of the national vaccination program from the perspective of the Tanzanian government. Cost data were collected in 2019 via surveys, workshops, and interviews with local stakeholders for vaccines and injection supplies, microplanning, training, sensitization, service delivery, supervision, and cold chain. The cost per two-dose and one-dose fully immunized girl (FIG) was calculated.

Results: The total financial and economic costs were US$10,117,455 and US$45,683,204, respectively, at a financial cost of $5.17 per two-dose FIG, and an economic cost of $23.34 per FIG. Vaccine and vaccine-related costs comprised the largest proportion of costs, followed by service delivery. In a one-dose scenario, the cost per FIG reduced to $2.51 (financial) and $12.18 (economic), with the largest reductions in vaccine and injection supply costs, and service delivery.

Conclusions: The overall cost of Tanzania's HPV vaccination program was lower per vaccinee than costs estimated from previous demonstration projects in the region, especially in a single-dose scenario. Given the WHO Strategic Advisory Group of Experts on Immunization's recent recommendation to update dosing schedules to either one or two doses of the HPV vaccine, these data provide important baseline data for Tanzania and may serve as a guide for improving coverage going forward. The findings may also aid in the prioritization of funding for countries that have not yet added HPV vaccines to their routine immunizations.

Keywords: C4P Tool; Costs; HPV vaccination; Tanzania.

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Figures

Fig. 1
Fig. 1
Estimated financial and economic costs in US$2019 per fully immunized girl (two-doses).
Fig. 2
Fig. 2
Estimated financial and economic costs in US$2019 per fully immunized girl (hypothetical one-dose scenario).
Fig. 3
Fig. 3
Sensitivity analysis of economic costs in US$2019 per fully immunized girl (two-doses).

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Source: PubMed

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