Examining the unit costs of COVID-19 vaccine delivery in Kenya

  1. Stacey Orangi
  2. Angela Kairu
  3. Anthony Ngatia
  4. John Ojal
  5. Edwine Barasa

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Abstract

Background

Vaccines are considered the path out of the COVID-19 pandemic. The government of Kenya is implementing a phased strategy to vaccinate the Kenyan population, initially targeting populations at high risk of severe disease and infection. We estimated the financial and economic unit costs of procuring and delivering the COVID-19 vaccine in Kenya across various vaccination strategies.

Methods

We used an activity-based costing approach to estimate the incremental costs of COVID-19 vaccine delivery, from a health systems perspective. Document reviews and key informant interviews( n  = 12) were done to inform the activities, assumptions and the resources required. Unit prices were derived from document reviews or from market prices. Both financial and economic vaccine procurement costs per person vaccinated with 2-doses, and the vaccine delivery costs per person vaccinated with 2-doses were estimated and reported in 2021USD.

Results

The financial costs of vaccine procurement per person vaccinated with 2-doses ranged from $2.89-$13.09 in the 30% and 100% coverage levels respectively, however, the economic cost was $17.34 across all strategies. Financial vaccine delivery costs per person vaccinated with 2-doses, ranged from $4.28-$3.29 in the 30% and 100% coverage strategies: While the economic delivery costs were two to three times higher than the financial costs. The total procurement and delivery costs per person vaccinated with 2-doses ranged from $7.34-$16.47 for the financial costs and $29.7-$24.68 for the economic costs for the 30% and 100% coverage respectively. With the exception of procurement costs, the main cost driver of financial and economic delivery costs was supply chain costs (47–59%) and advocacy, communication and social mobilization (29–35%) respectively.

Conclusion

This analysis presents cost estimates that can be used to inform local policy and may further inform parameters used in cost-effectiveness models. The results could potentially be adapted and adjusted to country-specific assumptions to enhance applicability in similar low-and middle-income settings.

Article activity feed

  1. Version published to 10.1186/s12913-022-07864-z
  2. ScreenIT

    SciScore for 10.1101/2021.11.01.21265742: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Cost components: The different activities identified in the delivery and implementation of the COVID-19 vaccine were categorized under 7 key components; 1) Vaccine and related supplies procurement costs 2) Vaccine supply chain costs 3) Vaccine safety monitoring and AEFI management 4) Training 5) Advocacy, communication, and social mobilization 6) Data management, monitoring and supervision 7)Vaccine administration during service delivery.
    Cost
    suggested: (COST, RRID:SCR_014098)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study’s limitation is that the study relied on expenditure plans rather than actual expenditures. However, this was mitigated by augmenting this data with structured interviews with vaccine deployment implementors. The strength of this paper is that the assumptions, unit prices, and vaccination scenarios used in the cost analysis are country-specific and therefore can be used to inform local policy and may further inform parameters used in cost-effectiveness models. However, although the results are less generalizable to other similar low-and middle-income settings in the current format, they could potentially be adapted and adjusted to country-specific assumptions.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.11.01.21265742v1 on medRxiv