PATH’s new Rotavirus Vaccine Cost Calculator helps countries estimate the cost of vaccination programs based on factors such as product presentation and cold chain volume. Here, rotavirus vaccines are kept cold in a refrigerator at Dangme West District Hospital, Ghana. PATH/Doune Porter

When country decision-makers have the option to introduce a new vaccine into their national immunization program, they have many considerations to weigh. Is the vaccine needed? What would be the benefits? Is there enough capacity within the country’s cold chain system (e.g., freezers, delivery trucks)? And—often one of the most critical questions—what will it cost, and can my country afford it? Deciding how to make the best use of a country’s often-limited resources is no easy task.

For vaccines against rotavirus, the leading cause of severe and fatal childhood diarrhea, decision-making has become more challenging in recent years because of fluctuating market forces and an increasing number of rotavirus vaccine product options. Having a diverse vaccine market is beneficial for supply and affordability, but it can make it more complex for countries to choose a vaccine. And with more than 100 countries having already introduced rotavirus vaccine, the addition of these new products also allows some countries to consider switching to a new vaccine. The question of cost, in particular, is further complicated by the fact that some costs are hidden below the surface. For example, even if a vaccine’s price is lower, the overall cost needs to encompass other expenses such as additional cold chain equipment or personnel, training, or wastage due to differences in presentation.

The Health Economics and Outcomes Research (HEOR) team within PATH’s Center for Vaccine Innovation and Access seeks to help inform the process of vaccine decision-making. While the ultimate decision still comes down to country preferences, as informed by many considerations, we wanted to help clarify the cost factor for rotavirus vaccines. To do this, we developed a tool called the Rotavirus Vaccine Cost Calculator.

The calculator is an Excel-based tool that enables simple estimation and comparison of the costs of rotavirus vaccination programs. With only a limited number of data inputs required, it allows users to compare up to six different vaccine product options at a time and produces cost estimates both annually and over a period of 10 years. We hope that this tool will prove useful to decision-makers, implementers, technical partners, and others in any country, regardless of eligibility for co-funding from Gavi, the Vaccine Alliance. The tool can be used by countries introducing rotavirus vaccine for the first time or countries considering a switch from one rotavirus vaccine product to another, such as Ghana’s recent switch from ROTARIX® to ROTAVAC®. The tool includes a user guide and is available to download in English, French, and Spanish (with Russian coming soon!).

While the Rotavirus Vaccine Cost Calculator provides insights into the potential costs of alternative rotavirus vaccine product choices, it does not account for other dimensions in decision-making and is not a replacement for detailed budget planning once a product has been selected.

Making decisions about the use of public resources for national immunization programs is not simple. We know that rotavirus vaccines work and are generally cost-effective, but choosing which vaccine to use, how to introduce it, and how to budget for it in order to maximize sustainability requires thinking carefully through the options. It is our hope that this new tool will make that process just a little bit simpler and, as a result, that more countries will be able to protect children from rotavirus diarrhea for years to come.

For questions or support in using or sharing the Rotavirus Vaccine Cost Calculator, contact the HEOR team: HEOR@path.org.

Note: Vaccine Cost Calculators for other vaccines, including pneumococcal conjugate vaccines (PCVs) and human papillomavirus (HPV) vaccines, are in development. Check this page for updates!