Cost analysis of overseas versus domestic vaccination of US-bound refugees

The Vaccination Program for US-bound Refugees (VPR) offers selected vaccines to refugees abroad before their resettlement to the United States. The study compared federal government costs for VPR and post-arrival vaccination in the USA using 2024 data across five regions. The VPR program resulted in average savings of $147 per person, representing $14.7 million per 100,000-refugee cohort compared to the scenario where all vaccines would be administered after arrival in the USA. VPR was cost-saving in most regions, with the highest savings at International Organization for Migration (IOM) sites in Africa ($333 per person). The only exception was IOM sites in Europe, where additional costs of $44 per person were observed. The VPR program remains an effective strategy that protects refugee health and US health security.