Resource Needs for the Trivalent Oral Polio to Bivalent Oral Polio Vaccine Switch in Indonesia

Abstract

Background.We present an empirical economic cost analysis of the April 2016 switch from trivalent (tOPV) to bivalent (bOPV) oral polio vaccine at the national-level and 3 provinces (Bali, West Sumatera and Nusa Tenggara) for Indonesia’s Expanded Program on Immunization.Methods.Data on the quantity and prices of resources used in the 4 World Health Organization guideline phases of the switch were collected at the national-level and in each of the sampled provinces, cities/districts, and health facilities. Costs were calculated as the sum of the value of resources reportedly used in each sampled unit by switch phase.Results.Estimated national-level costs were $46 791. Costs by health system level varied from $9062 to $34 256 at the province-level, from $4576 to $11 936 at the district-level , and from $3488 to $29 175 at the city-level. Estimated national costs ranged from $4 076 446 (Bali, minimum cost scenario) to $28 120 700 (West Sumatera, maximum cost scenario).Conclusions.Our findings suggest that the majority of tPOV to bOPV switch costs were borne at the subnational level. Considerable variation in reported costs among health system levels surveyed indicates a need for flexibility in budgeting for globally synchronized public health activities.

Polio and Its Epidemiology

“…Eradication, which is tantalizingly close, will require substantial changes in vaccination policy and practice [160]. We have witnessed the disruptions that were caused in routine vaccination programs and in all facilities in every country including PEFs and non-PEFs within the global polio laboratory network when WPV2 was declared eradicated and phase 2 of GAP III put into operation for containment of material containing or potentially containing PV2 [381,[383][384][385][386][387][388][389][390][391][392][393][394][395][396]. Eradication of WPV3 will be declared in the very near future.…”

Cold chain and virus‐free oral polio booster vaccine made in lettuce chloroplasts confers protection against all three poliovirus serotypes

“…Continued use of serotype 2 in oral polio vaccine (OPV) led to 683 cases of polio caused by circulation of vaccine-derived poliovirus type 2 (cVDPV2) between 2000and 2014(McCarthy et al, 2017. Therefore, WHO Global Polio Eradication Initiative recommended withdrawal of the type 2 component (OPV2) in April 2016 and replacing bivalent OPV (bOPV) in all 155 countries and territories that had used OPV in 2015 (Holmes et al, 2017;Ramirez Gonzalez et al, 2017). The Strategic Advisory Group of Experts (SAGE) proposed that during the transition, a single dose of inactivated poliovirus vaccine (IPV) may be adequate to prime global population due to the high cost and inadequate supply of IPV.…”