New Approaches to Immunization Logistics
Simona Zipursky, Debra Kristensen and Michel Zaffran
Since the launch of the Expanded Programme on Immunization in the mid-1970s, most developing countries have been using the same standard package of six vaccines – to prevent measles, tetanus, diphtheria, whooping cough (pertussis), tuberculosis (TB) and polio. Over the last decade, however, as the public-health impact of vaccines has become increasingly recognized, funding for new vaccine development has surged.
Today, most countries have incorporated hepatitis B vaccine into their infant immunization programs. Many have added Haemophilus influenzae type b vaccine and are considering pneumococcal and rotavirus vaccines. Uganda and Vietnam have even conducted demonstration projects with the recently licensed human papillomavirus vaccine. Throughout the next decade, countries will have opportunities to introduce many new lifesaving vaccines – in some cases doubling the number of vaccines offered in their programs. This is great news for the children, adolescents, and adults who will receive them, but it places an increasing burden on the systems responsible for their delivery.
Part of the challenge stems from the differences between the traditional six vaccines and their new counterparts. Traditional vaccines such as measles, diphtheria-tetanus-pertussis, and oral polio are now relatively inexpensive, in general costing between US$0.14 and $0.23 per dose. By comparison, new vaccines are priced between $3.50 and $15 per dose – even when purchased in large quantities for developing countries. Although prices will likely decrease over time, it is unlikely that they will ever be as low as traditional vaccines due to the complexity required to manufacture them.
