The Cost of Delivering COVID-19 Vaccines in Four Districts in Malawi 

This study provides the first primary data-based estimate of COVID-19 vaccine delivery costs in Malawi, analyzing expenses from 20 health facilities across four districts between April 2021 and March 2022. It found the financial cost per vaccine dose delivered was US$4.55, while the economic cost—including staff time reallocation, volunteer labor, and donated resources—was significantly higher at US$16.15 per dose, with labor alone accounting for two-thirds of that total. The research highlights key cost drivers and variability, offering important insights for better budgeting and planning in low-income countries, and contributes to a growing body of evidence comparing real-world costs to global delivery cost models.