Routine immunization services costs and financing in China, 2015.

Area of Science:

• Public Health
• Health Economics
• Vaccinology

Background:

• Routine immunization (RI) is crucial for child health.
• Understanding the costs of RI services is vital for effective public health investment.
• China's Expanded Program on Immunization (EPI) requires accurate cost data for strategic planning.

Purpose of the Study:

• To estimate the total costs of routine immunization services in China for 2015.
• To provide data for investment decisions in the Expanded Program on Immunization (EPI).
• To contribute to global knowledge on the costing and financing of routine immunization.

Main Methods:

• A random sampling of villages, townships, counties, and prefectures across 15 provinces was conducted.
• Direct costs (vaccines, personnel, cold chain, etc.) and indirect costs (parental transportation, lost productivity) were analyzed.
• Financial data was collected from governmental and external sources.

Main Results:

• Total direct costs for routine immunization were $92.42 per child ($1529.55 million per birth cohort).
• Regional cost variations were observed, with higher costs in eastern China.
• Vaccine costs represented 20.64% of total costs, while operational costs accounted for 14.21%.

Conclusions:

• Government investment covers approximately 70% of total RI costs, with private vaccine sales funding the remainder.
• China can enhance its EPI by incorporating new and underutilized vaccines, supported by cost-effectiveness evidence.
• Continued government support and strategic integration of vaccines are essential for strengthening immunization programs.