Vaccine · 2026
Evaluating the delivery costs and operational context of a single-dose human papillomavirus (HPV) vaccine regimen administered to a multi-age cohort of adolescent girls in Ethiopia.
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Mvundura Mercy, Slavkovsky Rose, Dagnew Belayneh, Hunduma Alemayehu, Ayalew Melkamu, Bedada Diriba
Аннотация
INTRODUCTION: The World Health Organization recently endorsed an alternative single-dose human papillomavirus (HPV) vaccination regimen based on high-quality evidence of its comparable efficacy and duration of protection as multiple doses. Real-world evidence is lacking on the program cost implications and operational context associated with the new regimen. Our study aimed to evaluate the delivery costs and describe the program context of delivering a single-dose HPV vaccine regimen to a multi-age cohort (MAC) of 9-14 year-old girls, using data from Ethiopia's vaccination campaign conducted in late 2024.
METHODS: This was a cross-sectional retrospective study combining operations research and micro-costing methods. We collected primary data on program activities at 82 health facilities in four selected regions and at the associated subnational and national administrative levels. Operations data were tabulated as counts and frequencies to characterize the program context. Delivery costs including financial costs (monetary outlays) and economic costs (financial plus opportunity costs) were estimated. Costing was done from the health system perspective and reported in 2024 United States dollars (US$).
RESULTS: Staff from 90% of health facilities in our sample conducted HPV vaccination sessions at schools and 73% conducted outreach, with an average of 910 HPV vaccine doses delivered per facility. While most health facilities and administrative offices conducted additional program activities, their intensity differed by level of the health system. On average, opportunity costs were the larger share of delivery costs (79%) at health facilities, while at administrative levels it was financial costs (at least 52%). Delivery costs aggregated across all levels of the health system were $0.66 for financial costs and $1.67 for economic costs per dose or per adolescent girl receiving the single-dose regimen.
CONCLUSION: A single-dose HPV vaccination regimen administered to a MAC resulted in low delivery costs and may be a way for HPV vaccination programs to reduce costs and enhance sustainability.
METHODS: This was a cross-sectional retrospective study combining operations research and micro-costing methods. We collected primary data on program activities at 82 health facilities in four selected regions and at the associated subnational and national administrative levels. Operations data were tabulated as counts and frequencies to characterize the program context. Delivery costs including financial costs (monetary outlays) and economic costs (financial plus opportunity costs) were estimated. Costing was done from the health system perspective and reported in 2024 United States dollars (US$).
RESULTS: Staff from 90% of health facilities in our sample conducted HPV vaccination sessions at schools and 73% conducted outreach, with an average of 910 HPV vaccine doses delivered per facility. While most health facilities and administrative offices conducted additional program activities, their intensity differed by level of the health system. On average, opportunity costs were the larger share of delivery costs (79%) at health facilities, while at administrative levels it was financial costs (at least 52%). Delivery costs aggregated across all levels of the health system were $0.66 for financial costs and $1.67 for economic costs per dose or per adolescent girl receiving the single-dose regimen.
CONCLUSION: A single-dose HPV vaccination regimen administered to a MAC resulted in low delivery costs and may be a way for HPV vaccination programs to reduce costs and enhance sustainability.