Just ₹147 to help protect a kid from diseases in India

NEWDELHI: The per dose per child cost of routine vaccination in India is ₹147 (US$2.29), found a micro-level scale study of the world’s largest public vaccination programme that targets to vaccinate 2.6 crore (26 million) newborns against 11 vaccine-preventable diseases.

The cost per dose per child ranges widely between ₹88 (US$1.38) and ₹187 (US$ 2.93) across states, with the cost being lower in centres and districts that vaccinated more children, found the study based on a random sample of 255 public health facilities from 24 districts across seven states -Bihar, Gujarat, Kerala, Meghalaya, Punjab, Uttar Pradesh and West Bengal.

The cost of fully immunising a child (the third dose of DPT vaccine is a proxy for full immunisation) ranged widely from ₹1,285 (US$20.08) to ₹2,228 (US$34.81), according to the study published in the BMJ Global Health.

India allocated around ₹1,600 (US$25) per child for full immunisation under Universal Immunisation Programme (UIP), under which more than 90 lakh immunisation sessions are conducted annually.

“There’s been a four-fold increase in the immunisation budget over the last four years, yet no proper economic costing study has been done. This study is significant because with the addition of more life-saving vaccines, as it should happen, the budget will go up further,” said study co-author Ramanan Laxminarayan from Princeton University.

“The study gives answer to the basic question -- how much does it cost the government to vaccinate one child”? , said lead author Sushmita Chatterjee, from the Public Health Foundation of India.

“The per dose cost estimates are lower than in other country studies... our estimates are lower probably because the majority of the vaccines are produced in India a large birth cohort every year, which lowers per unit cost,” said Chatterjee.

While local manufacturing and high volumes to fully immunise a birth cohort of 26 million children each year brings down costs, the wastage remained very high, ranging from a high 56% for BCG to 27% for the pentavalent vaccine, which was the least wasted.

“The wastage rates are very high, indicating better efficiencies in aggregating children for vaccination. A BCG vial is used for 10 children, but if only two show up for vaccination, it leads to 80% wastage,” said Laxminarayan.

It’s a dynamic programme, maintain government officials. “More vaccines have been included in the UIP over the past five years but we have reduced the number of polio rounds, from six national and 12 sub-national to two of each, which has saved costs. Immunisation is a priority programme that is constantly reviewed to improve coverage,” said Dr Pradeep Haldar, deputy commissioner, immunisation division, ministry of health and family welfare.