Table 3.
Vaccine | Prevnar® | Rotateq® | Gardasil® |
---|---|---|---|
Target population | 376,202 infants 0-1 years in 2010 | 394,473 infants 0-1 years in 2012 | 91,317 girls in P6 in school (9-18 years) and 3,066 girls who were out of school and 12 years old |
Number of doses per child | 3 | 3 | 3 |
Price of Vaccine | Financial: $0.20 per dose co-financing Economic: $3.50/dose |
Financial: $0.20 per dose co-financing Economic: $5.00/dose |
Vaccines donated during 1st three years but MoH paid for syringes, receiving, clearance and storage; assumed $5.00/dose for economic costs (not inclusive of costs of receiving and storage of the vaccine) |
Type of Vaccine, presentation and cold chain volume | Prevnar® in prefilled syringe for intramuscular injection, 55.9 cc | RotaTeq® in single dose applicator for oral administration, 46.3 cc | Gardasil® in single dose vial with separate syringe for intramuscular injection, 15 cc. |
Administrative Vaccine Coverage | First dose coverage was reported to be 80%, then dropout of approximately 1% occurred for each of the 2nd and 3rd doses | Assume 80% coverage for 1st dose, with 1% and 0.5% dropout rates for 2nd and 3rd doses | First dose was reported to be 97% with dropout of 2% occurred for each of the 2nd and 3rd doses |
Country Co-financing for Gavi | Rwanda began co-financing Prevnar®a in 2010 at $0.20/dose | Co-financing will begin in 2012 at $0.20/dose | NA |
Introduction Costs (Micro-planning, training, Soc.Mob./IEC) | Assumed to last five years | Assumed to last five years | Assumed to last five years |
Cold Chain | bHalf of the cold chain equipment purchased for Prevnar was later used for HPV vaccines | New refrigerators were purchased for Rotateq®.for the district (87) and health center levels (131). | bHalf of the cold chain equipment purchased for Prevnar was later used for HPV vaccines |
Service delivery | Six minutesc vaccinator time per vaccination in clinic | Six minutes vaccinator time per vaccination in clinic | Six minutesc vaccinator time per vaccination in clinic Health worker outreach allowances (5000 Rwanda francs or approximately $8) for visiting each school; 2,510 schools were visited by teams of 2 health workers |
Supervision | Supervisory trips three times a year: Travel allowance, per diem, fuel; staff salaries; 20% allocated to PCV | Supervisory trips three times a year: Travel allowance, per diem, fuel; staff salaries; 20% allocated to RV | Supervision takes place during HPV vaccination and included in cost of service delivery |
Monitoring and evaluation | Printing of new vaccination cards and tally sheets, post-introduction evaluation, surveillance | Printing new vaccination cards, post-introduction evaluation, surveillance | Printing new vaccination cards, post-introduction evaluation, surveillance |
Waste management | Incineration and Burial of prefilled syringes; | Incineration and Burial; Disposal of plastic dosing tubes | Incineration and Burial |
Rwanda obtained Prevnar as a donation from Wyeth, the manufacturer, in 2009 and the government only paid for transport, receiving and clearance; it began getting the vaccine through Gavi in 2010 and paying the co-financing fees.
Since 50% of the cold chain costs for the Prevnar introduction were actually attributed to Gardasil introduction, the costs of introducing Prevnar was slightly underestimated.
Based on program manager estimates.