233395 Cost of mass vaccination against H1N1 influenza: A comparison of two New York City campaigns

Sunday, November 7, 2010

Meghan D. McGinty, MPH, MBA, CPH , Office of the Chief Operating Officer, NYC Department of Health and Mental Hygiene, New York, NY
Susan M. Kansagra, MD, MBA , Office of the Commissioner, NYC Department of Health and Mental Hygiene, New York, NY
Beth Maldin Morgenthau, MPH , Office of Emergency Preparedness and Response, NYC Department of Health and Mental Hygiene, New York, NY
Monica L. Marquez, MPH , Office of Emergency Preparedness and Response, NYC Department of Health and Mental Hygiene, New York, NY
Annmarie Rosselli-Fraschilla, MSA , Office of Emergency Preparedness and Response, NYC Department of Health and Mental Hygiene, New York, NY
Jane R. Zucker, MD, MSc , Bureau of Immunization, New York City Department of Health and Mental Hygiene, New York, NY
Thomas A. Farley, MD, MPH , NYC Department of Health and Mental Hygiene, New York, NY
Background: In fall 2009, the New York City Department of Health and Mental Hygiene (DOHMH) launched one of the nation's largest efforts including a school-located campaign and a community-based Point of Dispensing (POD) campaign to deliver influenza A (H1N1) 2009 monovalent vaccine. The objective of this study was to estimate and compare total campaign costs and costs per dose.

Methods: Expenses including personnel, supplies/equipment, logistics and overhead were calculated in 2009-2010 U.S. dollars from DOHMH's perspective. Costs were obtained from invoices or estimates of expended resources. Vaccination data were obtained from the Citywide Immunization Registry and POD reports. Maximum capacity was estimated by applying the number of doses administered at high performing sites to all schools and PODs.

Results: The school-located campaign delivered an estimated 240,205 vaccines at a cost of $17.6 million and cost per dose of $73. PODs delivered 49,986 vaccines at a cost of $7.5 million and cost per dose of $150. At projected maximum capacity, the school-located campaign could have delivered 312,616 doses at $59 each, and PODs could have administered 174,000 doses at $50 each.

Conclusions: Successful implementation of both campaigns required significant resources. As conducted, the school-located campaign delivered vaccines at a lower cost per dose than PODs and was particularly effective at reaching children. With higher demand, both campaigns may have delivered vaccine at lower, more comparable costs per dose; they should both be considered as effective strategies for increasing vaccination coverage during future emergencies.

Learning Objectives:
1. Describe resources associated with operating mass vaccination campaigns. 2. Identify which expenses accounted for the largest proportion of total campaign cost and cost per dose administered. 3. Compare the cost efficiency of school-located versus community-based mass vaccination.

Keywords: Cost Issues, Immunizations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversaw staffing of the H1N1 vaccination campaigns.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
CDC NA I am grant funded by the CDC

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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