Cost Comparison of Two Mass Vaccination Campaigns Against H1N1 Influenza In New York City

Background: Mass vaccination is a major focus of U.S. health preparedness, but there have been few opportunities to exercise relevant approaches. In 2009, the New York City Department of Health and Mental Hygiene launched a large vaccination effort –including a school-located campaign and a community-based Points of Dispensing (PODs) campaign – to deliver influenza A (H1N1) 2009 monovalent vaccine.

Objectives: To estimate and compare total costs and costs per dose administered at baseline and if demand for vaccination had been higher.

Methods: Costs for personnel, logistics, and overhead were determined from invoices or estimated. Value of supplies and vaccine provided in-kind by the US government were also included. Vaccination data were obtained from the Citywide Immunization Registry and POD reports.  Projected 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 approximately 240,205 vaccines for $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 capacity, the school-located campaign could have delivered 312,616 doses at $59 each or $16 each when excluding the value of in-kind resources. PODs could have administered 174,000 doses at $50 each or $24 each when excluding the value of in-kind resources.

Conclusions: The school-located campaign delivered vaccines at a lower cost per dose than PODs.  Had demand been higher, PODs and the school-located campaign may have delivered vaccine at lower, more comparable cost per dose.  Both campaigns were aspects of a larger vaccination effort and were important approaches to increase vaccination coverage and should be considered during emergency and non-emergency situations.