Vaccine Evidence Compendium

Hexavalent vaccines

Financing & funding

Estimated financial cost of materials per vaccine dose (syringes, needles, safety box) (in USD)

Cost of syringes: UNICEF procurement 0.028$ to 0.065$ depending on supplier and product / PAHO RF procurement 0.028$ to 0.048$ depending on supplier and product. 

Cost of safety boxes: UNICEF procurement, a box of 25 safety boxes (each with a 5-liter capacity) is about $20.26, resulting in approximately $0.81 per safety box. Each 5-liter safety box can hold around 100 syringes, leading to a disposal cost of approximately $0.008 per syringe. ,

Estimated vaccine financial cost per dose (in USD)

In Gavi-supported countries, Serum Institute of India (SII) has offered a price of $2.85 per dose in the 10 dose presentation for hexavalent vaccines (wP). 
For fully self-financing countries and those eligible under Gavi's Middle-Income Countries (MICs) Approach, the cost of SII's hexavalent vaccine is $3.00 per dose. 
For fully self-financing MICS, the cost of hexavalent vaccines (aP containing) is on average $28.8 per dose. 

The UNICEF price for the pentavalent vaccine is $0.85-$1.26 per dose for Gavi supported-countries depending on supplier and presentation . 
The PAHO price is $1.18 per dose (wP) and ranges between $18.33 and $21.54 for vaccines with aP depending on supplier and presentation. 
For fully self-financing MICS, the cost is $1.25-$2.29 per dose (DTwP-HepB-Hib). 

UNICEF prices for the IPV vaccine for countries assessing Gavi prices range between $1.25 and $2.8 depending on supplier and presentation. 
UNICEF price for self-procuring MICs is €3.1 per dose. 
The PAHO price ranges between $1.25 and $5.5 per dose. 
For fully self-financing MICS, the cost ranges from $2.23 to $10.66 per dose. 

Estimated financial cost per person vaccinated (in USD)

In European countries with vaccine procurement through public tenders the price per child vaccinated with standard vaccines ranged from €59 to €117 when using pentavalent and from €98 to €220 when using hexavalent vaccines, both with aP. 
A 2022 a study focused on Peru estimated the total cost of fully vaccinating a child with the hexavalent vaccine (DTaP-HB-Hib-IPV) at $126.42, compared to $116.27 under the existing schedule using the current scheme (DTwP-HB-Hib + IPV + OPV). 

Cost-effectiveness ratio

While hexavalent vaccines may have higher upfront costs, they can help reduce adverse events, logistical challenges, and overall societal burdens, offering potential economic and practical benefits for immunization programs, as demonstrated by studies from countries including Peru (wP pentavalent compared to aP hexavalent), Argentina (wP pentavalent compared to aP hexavalent), Colombia (aP compared to wP hexavalent vaccines), and South Korea (DTaP-IPV-Hib-HepB compared to DTaP-IPV/Hib). , , , , , ,      

Is there a Gavi programme to support the introduction of this vaccine? If a Gavi programme is available, what support is available to countries?

In December 2023, Gavi opened a funding window for eligible countries to switch from pentavalent to hexavalent vaccine, including assistance in assessing financial, logistical, and programmatic implications to determine suitability for their specific contexts. Operational support is also available to facilitate the introduction of the hexavalent vaccine into national immunization programs. ,  

Sources

  • UNICEF (2025). Auto-disable (AD) syringe price data. Available at: https://www.unicef.org/supply/documents/auto-disable-ad-syringe-price-data (accessed 30 June 2025).

  • UNICEF (2025). Safety boxes price data. Available at: https://www.unicef.org/supply/documents/safety-boxes-price-data (accessed 30 June 2025).

  • UNICEF (2025). Syringe and safety box bundles price data. Available at: https://www.unicef.org/supply/documents/syringe-and-safety-box-bundles-price-data (accessed 30 June 2025).

  • Gavi (2023). Hexavalent vaccine programme information. Available at: https://www.gavi.org/our-support/guidelines/hexavalent-vaccine-programme-information (accessed 30 June 2025).

  • UNICEF (2024). DTP-HepB-IPV-Hib vaccine prices [PDF]. Available at: https://www.unicef.org/supply/media/21171/file/DTP-HepB-IPV-Hib-vaccine-prices-05042024.pdf (accessed 30 June 2025).

  • World Health Organization (WHO) (2025). MI4A vaccine purchase data. Available at: https://www.who.int/teams/immunization-vaccines-and-biologicals/vaccine-access/mi4a/mi4a-vaccine-purchase-data (accessed 30 June 2025).

  • UNICEF (2022). DTP-HepB-Hib-Penta vaccine prices [PDF]. Available at: https://www.unicef.org/supply/media/15346/file/DTP-HepB-Hib-Penta-vaccines-prices-27122022.pdf (accessed 30 June 2025).

  • Pan American Health Organization (PAHO) (2025). Revolving fund vaccine prices. Available at: https://www.paho.org/en/documents/revolving-fund-vaccine-prices-2025 (accessed 30 June 2025).

  • UNICEF (2024). IPV vaccine prices [PDF]. Available at: https://www.unicef.org/supply/media/22786/file/IPV-vaccine-prices-28102024.pdf (accessed 30 June 2025).

  • Salo, H., Sakalauskaitè, M., Lévy-Bruhl, D., Lindstrand, A., Valentiner-Branth, P., Wichmann, O. & Puumalainen, T. (2023). Prices of paediatric vaccines in European vaccination programmes. Vaccine X, 15, 100392. doi:10.1016/j.jvacx.2023.100392.

  • Seinfeld, J., Rosales, M.L., Sobrevilla, A. et al. (2022). Economic assessment of incorporating the hexavalent vaccine as part of the National Immunization Program of Peru. BMC Health Services Research, 22, 651. doi:10.1186/s12913-022-08006-1.

  • Seinfeld, J., Rosales, M.L., Sobrevilla, A. & López Yescas, J.G. (2022). Economic assessment of incorporating the hexavalent vaccine as part of the National Immunization Program of Peru. BMC Health Services Research, 22(1), 651. doi:10.1186/s12913-022-08006-1.

  • Olivera, I., Pérez, C.G., Lazarov, L., Lopez, E., Oddo, C. & Dibarboure, H. (2023). Cost minimization analysis of a hexavalent vaccine in Argentina. BMC Health Services Research, 23(1), 1067. doi:10.1186/s12913-023-10038-0.

  • Romero, M., Góngora, D.-S., Caicedo, M.-L., Benchabane, D. & Lopez, J.-G. (2021). Cost-Minimization and Budget Impact Analysis of a Hexavalent Vaccine (Hexaxim®) in the Colombian Expanded Program on Immunization. Value in Health Regional Issues, 26, 150–159. doi:10.1016/j.vhri.2021.06.001.

  • Min, S., Kwon, S.H., Lee, Y.W., Lee, J.M., Bae, E.J. & Lee, E.K. (2023). Estimating the Total Societal Cost of a Hexavalent Vaccine versus a Pentavalent Vaccine with Hepatitis B in South Korea. Vaccines (Basel), 11(5), 984. doi:10.3390/vaccines11050984.

  • Olivera, M., Soto, J., Llamas, L.M., Reyes, N., Cid, M., et al. (2020) ‘Valuing the cost of improving Chilean primary vaccination: a cost minimization analysis of a hexavalent vaccine’, BMC Health Services Research, 20, p. 295. https://doi.org/10.1186/s12913-020-05115-7

  • Aljunid, S.M., Ismail, A., Nor, N.M., Zafar, A., Suleiman, A., et al. (2022) ‘Economic impact of switching from partially combined vaccine “Pentaxim® and hepatitis B” to fully combined vaccine “Hexaxim®” in the Malaysian National Immunization Program’, BMC Health Services Research, 22, p. 34. https://doi.org/10.1186/s12913-021-07428-7

  • Mogale, M., Burnett, R.J., Olivier, D., Mphahlele, J. (2014) ‘Economic assessment of implementing Hexaxim® vaccine within the South African Expanded Programme on Immunisation (EPI-SA)’, International Journal of Infectious Diseases, 21(Suppl.), pp. 1–460 (Abstract, 16th ICID).

  • Gavi (2024). Gavi vaccine funding guidelines. Available at: https://www.gavi.org/news/document-library/gavi-vaccine-funding-guidelines (accessed 30 June 2025).

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