Costs of, and reimbursement for, vaccines: a case study at the Board of Health Refugee Services in DeKalb county, Georgia.
BACKGROUND
Approximately 70,000 refugees are resettled to the United States each year. Providing vaccination to arriving refugees is important to both reduce the health-related barriers to successful resettlement, and protect the health of communities where refugees resettle. It is crucial to understand the process and resources expended at the state/local and federal government levels to provide vaccinations to refugees resettling to the United States.


OBJECTIVE
We estimated costs associated with delivering vaccines to refugees at the Board of Health Refugee Services, DeKalb county, Georgia (DeKalb clinic).


METHODS
Vaccination costs were estimated from two perspectives: the federal government and the DeKalb clinic. Data were collected at the DeKalb clinic regarding resources used for vaccination: staff numbers and roles; type and number of vaccine doses administered; and number of patients. Clinic costs included labor and facility-related overhead. The federal government incurred costs for vaccine purchases and reimbursements for vaccine administration.


RESULTS
The DeKalb clinic average cost to administer the first dose of vaccine was $12.70, which is lower than Georgia Medicaid reimbursement ($14.81), but higher than the State of Georgia Refugee Health Program reimbursement ($8.00). Federal government incurred per-dose costs for vaccine products and administrative reimbursement were $42.45 (adults) and $46.74 (children).


CONCLUSIONS
The total costs to the DeKalb clinic for administering vaccines to refugees are covered, but with little surplus. Because the DeKalb clinic 'breaks even,' it is likely they will continue to vaccinate refugees as recommended by the Centers for Disease Control and Prevention and the Advisory Committee on Immunization Practices.
Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, MS E-03 1600 Clifton Road, Atlanta, GA 30333, United States. kenji.adachi@bayer.com
Kenji
K
Adachi
Margaret S
MS
Coleman
Christopher
C
de la Motte Hurst
Monica L
ML
Vargas
Alawode
A
Oladele
Michelle S
MS
Weinberg
D000328:Adult; D002648:Child; D003153:Community Health Services / Q000191:economics; D005845:Georgia; D017048:Health Care Costs; D006801:Humans; D008484:Medicaid / Q000191:economics; D012036:Refugees; D012051:Reimbursement Mechanisms / Q000191:economics*; D014481:United States; D014611:Vaccination / Q000191:economics; D014612:Vaccines / Q000191:economics*; D000078329:Workforce
D014612:Vaccines