Evidence map›Paper›PMID 40108612›Full record

ArticleBMC health services research2025

Costs of delivering COVID-19 vaccine in Botswana during the height of the pandemic: a retrospective study.

Kelsey Vaughan, Onalenna T Mokena, Goabaone Rankgoane-Pono, Moses Keetile, Ulla Kou Griffiths

Abstract read
In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kelsey VaughanBang for Buck Consulting, Amsterdam, the Netherlands.
Onalenna T MokenaDepartment of Health Policy, Research and Development, Ministry of Health, Gaborone, Botswana.
Goabaone Rankgoane-PonoUniversity of Botswana, 4775 Notwane Rd, Gaborone, Botswana.
Moses KeetileDepartment of Health Policy, Research and Development, Ministry of Health, Gaborone, Botswana.
Ulla Kou GriffithsUNICEF, Health Programme, 3 UN Plaza, New York, NY, 10017, USA. ugriffiths@unicef.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe development, distribution and delivery of COVID-19 vaccines following the outbreak of the global coronavirus pandemic in February 2020 is the largest global immunization action in history. To assist with planning and resource mobilization efforts, a global-level model was used to estimate expected COVID-19 vaccine delivery costs employing data from the literature on childhood and adult flu vaccine delivery. However, country-level studies were needed to validate these estimates, learn lessons for future pandemics, and plan for forthcoming COVID-19 vaccination of priority groups.

methodsWe tested several methodological innovations to estimate total costs and costs per dose of COVID-19 vaccine delivery in Botswana. Costs incurred by all government sectors, parastatals, donors, and non-governmental organizations were included. Both fiscal costs (financial outlays) and the value of selected, existing human resources and donated vaccines (economic costs) were included.

resultsFiscal delivery costs of COVID-19 vaccination were estimated at US$49.8 million for a 13-month period, with over half accounting for newly hired human resources. Newly hired staff supported not just vaccine delivery, but also co-ordination and social mobilization efforts. The value of existing human resources deployed to support COVID-19 vaccination was US$36.6 million. Based on 2.6 million doses delivered, the fiscal and economic delivery cost per dose was US$19 and US$33, respectively. Vaccines were procured and donated at an average price per dose of US$13.46, increasing the economic cost per dose delivered to approximately US$47.

conclusionsIn Botswana, costs were substantially higher than modelled estimates for COVID-19 vaccine delivery and the costs of delivering routine childhood vaccines. This suggests that rolling out a new vaccine to an entire population in the middle of a pandemic requires additional financial investments beyond what has been typical for immunization services in the past.

Indexed as

COVID-19COVID-19 VaccinesImmunization ProgramsBotswanaHumansPandemicsRetrospective StudiesSARS-CoV-2COVID-19 VaccinesCostingCOVID-19 vaccinationDelivery costsImmunizationImmunization economicsVaccine

Identifiers

PMID40108612
PMCPMC11921734

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.