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Impact of the introduction of new vaccines and vaccine wastage rate on the cost-effectiveness of routine EPI: lessons from a descriptive study in a Cameroonian health district

DOI: 10.1186/1478-7547-9-9

Keywords: EPI (Expanded Program of Immunization), cost-effectiveness, FIC (Fully Immunized Child), Excess vaccine wastage, Pentavalent vaccine (DPT-HB-Hib), new vaccines, Cameroon, Ngong

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Abstract:

The results show that:? Only 62% of planned outreach immunization sessions were effectively carried out mainly due to limited funds for transportation and staff availability. Consequently vaccine coverage was low (BCG: 70.1%, DPT-HB-Hib 3: 55.5%) and less resources (43%) were used for this strategy which served 52% of the target population - a major blow to equity.? The average cost per Fully Immunized Child (FIC) was 9,571 FCFA (19.22 USD) for the fixed strategy; 12,751 FCFA (25.61 USD) for the outreach and 10,718 FCFA (21.53 USD) with both strategies combined. These figures are high than those observed in many other African health districts. However, DPT-HB-Hib and yellow fever vaccines contributed to the increase as vaccines occupied 57% of the total cost. With DPT in lieu of DPT-HB-Hib the cost/FIC would be 6,046 FCFA (12.14 USD). Dropout rates too were high (28.1% for the fixed, 29.7% for outreach).? The cost of vaccines wasted in excess of the national norm at the level of health centers was 595,532 FCFA (1,196.15 USD), an amount that could cover the vaccine cost for 122 FIC (7.6% of the FIC during the period). This was accounted for as follows: BCG 1.1%, OPV 1.4%, DPT-HB-Hib 72.7%, measles 5.3%, yellow fever 19.5%? Therefore we suggest improved communication for EPI, the introduction of DPT-HB-Hib with liquid Hib and the effective implementation of planned outreach sessions.Vaccines are costly and from many studies constitute a major burden for every immunization program [1,2]. With the introduction of the GIVS (Global Immunization, Vision and Strategy), immunization coverage objectives have been raised to reach more children (equity) and to cover more diseases. This involves the introduction of new vaccines and combinations which are generally more expensive. In this light, the Pentavalent vaccine, DPT-HB-Hib was introduced (in place of DPT) into the Expanded Program of Immunization (EPI) in Cameroon in February 2009, alongside the other traditional vaccines

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