HPV vaccines

If procuring through UNICEF SD: a box of 100 AD syringes with needles (0.5 ml) is priced at approximately US$ 4.50, equating to US$ 0.045 per syringe with needle; a box of 25 safety boxes (each with a 5-liter capacity) for about $20.26, resulting in approximately US$ 0.81 per safety box. Each 5-liter safety box can hold around 100 syringes, leading to a disposal cost of approximately US$ 0.008 per syringe. 

Combining these costs, the estimated material cost per HPV vaccine dose is approximately US$ 0.053 (i.e., US$ 0.045 for the syringe and needle plus US$ 0.008 for the share of the safety box).

UNICEF prices for 2025 for countries assessing GAVI prices, the price ranges between US$ 2.9 and US$ 5.18 per dose, depending on the suppler and presentation.For different groupings of MICs, UNICEF prices range between US$ 2.9 and US$ 33.25 for vaccines ranging from bivalent to nonavalent and depending on supplier.  ^{Go to footnote 11}

The PAHO price per dose for bivalent HPV vaccines is US$ 2.9 and for quadrivalent HPV vaccines US$ 10.48,as per 2024 price list. .^{Go to footnote 22}

Cost per dose in the USA, based on the CDC price list are US$182.79 or US$ 257.071 for nonavalent HPV vaccines depending on adult bs pediatric pricing.  ^{Go to footnote 33}

For self-procuring MICs, the price is on average US$ 9.54, US$ 56.38 and US$ 90.31 per dose for bi-, quadri- and nonavalent vaccines respectively, as per 2023 data^{Go to footnote 44}

Findings from a 6 country study published in November 2023 (Ethiopia, Guyana, Rwanda, Senegal, Sri Lanka, and Uganda) revealed that the financial cost per dose ranged from approximately US$ 1.50 to US$ 5.50, while the economic cost per dose varied between US$ 2.50 and US$ 7.50. These differences were influenced by factors such as service delivery strategies, the number of doses administered per health facility, and the intensity of program activities. Activities and expenditures at health facilities constituted the largest proportion of the economic cost per dose. Health worker and non-health worker time were substantial cost components, regardless of the operational context.  ^{Go to footnote 55}

A study in Zambia performed in 2020 estimated the financial costs for school based delivery were at US$ 12.4 per FIC (cost of vaccine is the co-financing portion only). ^{Go to footnote 66}

An older study in Tanzania and Uganda performed in 2011-2013 estimated the average introduction costs per fully immunized girl ranged from US$ 1.49 to US$ 18.94 while recurrent costs per girl ranged from US$ 1.00 to US$ 15.69.  ^{Go to footnote 77}

The cost of delivery can vary greatly depending on the strategies and the country context. For L&MICs, a study in Zimbabwe indicate a financial cost between US$ 3.31 per dose with school-only and US$ 48.69 per dose for routine delivery with multiple strategies in Zimbabwe.  ^{Go to footnote 88}

A study across six countries (Ethiopia, Guyana, Rwanda, Senegal, Sri Lanka) performed between 2015 and 2018 estimated the mean financial cost between US$ 0.27 to US$ 3.32/dose.^{Go to footnote 99}

Global cost-effectiveness analysis suggests that vaccinating pre-adolescent girls is usually cost-effective for cervical cancer prevention, particularly in resource-constrained settings where screening and other cervical cancer prevention and control measures often have limited coverage. At 2020 prices for the bivalent and quadrivalent vaccines, girls-only vaccination was cost-effective (compared with no vaccination) irrespective of the schedule or vaccine used.  ^{Go to footnote 1010, Go to footnote 1111} 

HPV vaccination is generally cost-effective or even cost-saving in both high- and low-income countries, especially when targeting girls aged 9–14 years. The mean incremental cost-effectiveness ratio (ICER) for HPV vaccination globally is estimated at US$ 4,217 per disability-adjusted life year (DALY) averted, with much lower ICERs in regions with high cervical cancer burden, such as Sub-Saharan Africa and South Asia.  ^{Go to footnote 1212}
In Latin America, most studies found HPV vaccination to be cost-saving or cost-effective, with mean ICERs ranging from I$ 358 to I$ 3,804 depending on the vaccine type and study parameters. ^{Go to footnote 1313}

Yes, there is a Gavi programme to support the introduction of the HPV vaccine. Gavi opened a funding window for HPV vaccines in 2013 and in 2023, it launched an HPV vaccination revitalisation effort to make additional resources and technical assistance available to countries. Gavi currently supports the introduction of HPV vaccines in routine immunization as well as Multi Age Cohort (MAC) campaigns. ^{Go to footnote 1414, Go to footnote 1515}