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. 2021 Nov 5;39(46):6796-6804.
doi: 10.1016/j.vaccine.2021.05.033. Epub 2021 May 25.

A systems map of the economic considerations for vaccination: Application to hard-to-reach populations

Sarah N Cox  1 , Patrick T Wedlock  1 , Sarah W Pallas  2 , Elizabeth A Mitgang  1 , Tatenda T Yemeke  3 , Sarah M Bartsch  1 , Taiwo Abimbola  2 , Sheryl S Sigemund  1 , Aaron Wallace  2 , Sachiko Ozawa  4 , Bruce Y Lee  5
Affiliations

A systems map of the economic considerations for vaccination: Application to hard-to-reach populations

Sarah N Cox et al. Vaccine. .

Abstract

Background: Understanding the economics of vaccination is essential to developing immunization strategies that can be employed successfully with limited resources, especially when vaccinating populations that are hard-to-reach.

Methods: Based on the input from interviews with 24 global experts on immunization economics, we developed a systems map of the mechanisms (i.e., necessary steps or components) involved in vaccination, and associated costs and benefits, focused at the service delivery level. We used this to identify the mechanisms that may be different for hard-to-reach populations.

Results: The systems map shows different mechanisms that determine whether a person may or may not get vaccinated and the potential health and economic impacts of doing so. The map is divided into two parts: 1) the costs of vaccination, representing each of the mechanisms involved in getting vaccinated (n = 23 vaccination mechanisms), their associated direct vaccination costs (n = 18 vaccination costs), and opportunity costs (n = 5 opportunity costs), 2) the impact of vaccination, representing mechanisms after vaccine delivery (n = 13 impact mechanisms), their associated health effects (n = 10 health effects for beneficiary and others), and economic benefits (n = 13 immediate and secondary economic benefits and costs). Mechanisms that, when interrupted or delayed, can result in populations becoming hard-to-reach include getting vaccines and key stakeholders (e.g., beneficiaries/caregivers, vaccinators) to a vaccination site, as well as vaccine administration at the site.

Conclusion: Decision-makers can use this systems map to understand where steps in the vaccination process may be interrupted or weak and identify where gaps exist in the understanding of the economics of vaccination. With improved understanding of system-wide effects, this map can help decision-makers inform targeted interventions and policies to increase vaccination coverage in hard-to-reach populations.

Keywords: Economic benefits; Hard-to-reach; Systems map; Vaccination costs.

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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.

Figures

Figure 1.
Figure 1.
Systems map of vaccination costs and economic impact
See this image and copyright information in PMC

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