The goal of the study was to provide data on the cost and funding for a) current vaccine safety systems in low- and middle-income countries (LMICs) and b) international vaccine safety initiatives. These data were collected to inform decisions on budgets and funding choices for the World Health Organization’s strategic plan for enhancing global vaccine safety activities. The study targeted 11 National Vaccine Safety Systems (NVSSs) as well as 13 International Vaccine Safety Initiatives (IVSIs) for the year 2009. However, due to a lack of available data, analysis is provided for five countries out of the 11 (Brazil, Iran, Mexico, Senegal, and Uganda). The average cost of NVSS per vaccine dose administered was US$0.03.

The average cost of NVSS per fully immunized child was US$0.53. This represents 2.27% of expenditure used for routine immunization on average over 2005-2010. Countries identified as having well-established AEFI surveillance systems (Brazil, Iran, and Mexico) had higher costs than countries with more basic systems (Senegal and Uganda). Personnel accounted for 81% of the NVSSs total costs on average. For funding of NVSSs, countries with the lowest budgets for vaccine safety were also the most dependent on external funding. The total cost for all IVSIs was US$4.3 million in 2009. The Bill & Melinda Gates Foundation contributed the largest amount for IVSIs at US$1.2 million (28%) and was the most frequent IVSI funder, providing support to 6 of the 13 initiatives.

Main Achievements in 2011: