Costs of routine immunization services in Moldova: Findings of a facility-based costing study

Vaccine. 2015 May 7;33 Suppl 1:A60-5. doi: 10.1016/j.vaccine.2014.12.034.


Objective: Available estimates on how much it costs to provide routine immunization services are out-dated. This study attempts to address gaps in evidence by evaluating the total economic and unit costs of delivering routine immunization (RI) services in Moldova as part of a multi-country study on the costs and financing of routine immunization (EPIC).

Methods: This cross-sectional study is based on a multistage stratified random sample of fifty primary health care facilities. Data on inputs, prices, and outputs were collected retrospectively for 2011 and analyzed using an ingredient-based costing approach in Excel and SPSS.

Results: The average total annual facility cost for RI was $11,943 ranging from $565 to $112,548 and labor cost was the main driver of routine immunization costs contributing 65%, followed by capital costs - 16.3% and the cost of vaccines and injection supplies accounting for 9%. The average cost per dose was $18.3, the cost per child was $316.6 and the cost per fully immunized child was $332.3. The results show considerable variation in the costs of routine immunization services across facility type and depending on a facility scale i.e. annual doses administered.

Conclusions: The study shows that the cost of fully immunizing a child in a middle-income country is much higher than previous estimates. These results will be used by the government for better planning and financing of routine immunization services, leading to greater sustainability.

Keywords: Cost-effectiveness; Costs; Moldova; Routine immunization; Sustainability.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross-Sectional Studies
  • Health Care Costs*
  • Health Facilities / economics
  • Health Personnel / economics
  • Health Services Administration / economics*
  • Humans
  • Immunization Programs / economics*
  • Immunization Programs / organization & administration
  • Infant
  • Infant, Newborn
  • Moldova
  • Random Allocation
  • Refrigeration / economics
  • Vaccination / economics*
  • Vaccination / methods
  • Vaccines / economics*
  • Vaccines / supply & distribution


  • Vaccines