Cost of reactive campaigns
A reactive vaccination campaign is expensive and provides no long-term protection
Reactive polysaccharide vaccination campaigns in 2009 in Niger and Nigeria targeted 7 million individuals and cost about US$15 million. Because immunity lasts only two or three years, countries soon find themselves having to repeat immunization.
A reactive vaccination campaign targeting one million persons costs in the vicinity of US$2 million. With multiple campaigns conducted simultaneously in different countries, the cost rapidly mounts.
For example, from 1999 to 2003, the seven so-called hyperendemic countries (Burkina Faso, Chad, Ethiopia, Mali, Niger, the nine northern states of Nigeria, and Sudan) purchased over 109 million doses of bivalent A/C polysaccharide vaccine. During the same period, other African countries purchased an additional 45 million doses. In fact, in the five years from 1999–2003, hyperendemic countries purchased enough polysaccharide vaccine to vaccinate one-half of their at-risk population. Burkina Faso, Mali, and Niger alone purchased 32 million doses of polysaccharide vaccine during this period, which was more than the estimated total combined population of individuals aged 1 to 29 years.
2007 epidemic in Burkina Faso in numbers (first 14 weeks of the year).
At an estimated average cost of US$0.55 for one dose of polysaccharide vaccine in 2000, this means that hyperendemic countries and/or donors spent US$60 million on the purchase of meningococcal polysaccharide vaccine alone. Combined with vaccine delivery costs, an estimated US$160 million was spent controlling meningitis epidemics. This disproportionate expenditure to combat meningitis epidemics has significantly compromised health budgets in meningitis belt countries.
Despite these investments, epidemics still occur. In 2006, nearly 90 percent of districts in Burkina Faso experienced meningitis epidemics in spite of the high vaccination coverage with meningococcal polysaccharide vaccines within the last five years.
Eliminating the need for purchase and delivery of meningococcal polysaccharide vaccine would benefits health care budgets by eliminating a high-cost item. These funds can be reprogrammed into strengthening other priority health initiatives such as routine immunization, malaria prevention and control, and maternal and child health interventions.