Systematic review of the incremental costs of interventions that increase immunization coverage |
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| Affiliation: | 1. Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA;2. Department of Maternal and Child Health, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA;3. Kid Risk, Inc., Columbus, OH, USA;1. Laboratory of Molecular Parasitology, Lindsley F Kimball Research Institute, New York Blood Center, New York, NY 10065, United States;2. Institute of Modern Biopharmaceuticals, School of Life Sciences, Southwest University, Chongqing 100045, China;3. Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States;4. Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY 10003, United States;5. Department of Biology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates;6. Department of Biology, Drexel University, Philadelphia, PA 19104, United States;7. Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, Beijing 400715, China;8. Texas Children’s Hospital Center for Vaccine Development, Department of Pediatric Tropical Medicine, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX 77030, United States;1. International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 855 N. Wolfe St., Suite 600, Baltimore, MD 21205, USA;2. Department of Industrial Engineering, University of Pittsburgh, 1033 Benedum Hall, Pittsburgh, PA 15261, USA;3. Department of Industrial Engineering, University of Pittsburgh, 1039 Benedum Hall, Pittsburgh, PA 15261, USA;4. Public Health Computational and Operational Research (PHICOR) Group, Johns Hopkins Bloomberg, School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA;5. Pittsburgh Supercomputing Center (PSC), Carnegie Mellon University, 300 S. Craig St., Pittsburgh, PA 15213, USA;1. Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States;2. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States;3. Global Obesity Prevention Center (GOPC), Johns Hopkins University, Baltimore, MD, United States;4. Pittsburgh Supercomputing Center (PSC), Carnegie Mellon University, Pittsburgh, PA, United States;5. McGill Centre for Integrative Neuroscience, McGill Neurological Institute, McGill University, Montreal, Canada;6. The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington, Seattle, WA, United States;7. Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States;8. Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina – Chapel Hill, Chapel Hill, NC, United States;9. Department of Maternal and Child Health, UNC Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, NC, United States;1. Berry Technology Solutions, USA;2. National Center for Immunization and Respiratory Diseases, CDC, USA;3. Epidemic Intelligence Service, CDC, USA;4. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, USA;5. School of Public Health and Tropical Medicine, Tulane University, USA;1. Harvard T.H. Chan School of Public Health, United States;2. Bill & Melinda Gates Foundation, United States;1. Public Health England, York, UK;2. Public Health England, Birmingham, UK;3. Public Health, Staffordshire University, Staffordshire, UK |
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| Abstract: | Achieving and maintaining high vaccination coverage requires investments, but the costs and effectiveness of interventions to increase coverage remain poorly characterized. We conducted a systematic review of the literature to identify peer-reviewed studies published in English that reported interventions aimed at increasing immunization coverage and the associated costs and effectiveness of the interventions. We found limited information in the literature, with many studies reporting effectiveness estimates, but not providing cost information. Using the available data, we developed a cost function to support future programmatic decisions about investments in interventions to increase immunization coverage for relatively low and high-income countries. The cost function estimates the non-vaccine cost per dose of interventions to increase absolute immunization coverage by one percent, through either campaigns or routine immunization. The cost per dose per percent increase in absolute coverage increased with higher baseline coverage, demonstrating increasing incremental costs required to reach higher coverage levels. Future studies should evaluate the performance of the cost function and add to the database of available evidence to better characterize heterogeneity in costs and generalizability of the cost function. |
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| Keywords: | Vaccination Cost Effectiveness Intervention Review |
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