Impact of changing the measles vaccine vial size on Niger's vaccine supply chain: a computational model

BMC Public Health

Research Article

Ali Djibo¹  Joel S Welling²  Anirban Jana²  Bryan A Norman³  Stephen R Wisniewski³  Angela R Wateska³  Bruce Y Lee³  Donald S Burke³  Sheng-I Chen³  Diana L Connor³  Rachel R Bailey³  Willem G Van Panhuis³  Jayant Rajgopal³  Tina-Marie Assi³  Shawn T Brown⁴  Hailu Kenea⁵  Souleymane Kone⁵ 

[1] Niger Ministry of Health, Niamey, Niger;Pittsburgh Supercomputing Centre, Pittsburgh, PA, USA;University of Pittsburgh, Pittsburgh, PA, USA;University of Pittsburgh, Pittsburgh, PA, USA;Pittsburgh Supercomputing Centre, Pittsburgh, PA, USA;World Health Organization, Geneva, Switzerland;

关键词: Measles Vaccine;    Vaccine Supply Chain;    Niger;   

DOI  :  10.1186/1471-2458-11-425

 received in 2011-01-25, accepted in 2011-06-02,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundMany countries, such as Niger, are considering changing their vaccine vial size presentation and may want to evaluate the subsequent impact on their supply chains, the series of steps required to get vaccines from their manufacturers to patients. The measles vaccine is particularly important in Niger, a country prone to measles outbreaks.MethodsWe developed a detailed discrete event simulation model of the vaccine supply chain representing every vaccine, storage location, refrigerator, freezer, and transport device (e.g., cold trucks, 4 × 4 trucks, and vaccine carriers) in the Niger Expanded Programme on Immunization (EPI). Experiments simulated the impact of replacing the 10-dose measles vial size with 5-dose, 2-dose and 1-dose vial sizes.ResultsSwitching from the 10-dose to the 5-dose, 2-dose and 1-dose vial sizes decreased the average availability of EPI vaccines for arriving patients from 83% to 82%, 81% and 78%, respectively for a 100% target population size. The switches also changed transport vehicle's utilization from a mean of 58% (range: 4-164%) to means of 59% (range: 4-164%), 62% (range: 4-175%), and 67% (range: 5-192%), respectively, between the regional and district stores, and from a mean of 160% (range: 83-300%) to means of 161% (range: 82-322%), 175% (range: 78-344%), and 198% (range: 88-402%), respectively, between the district to integrated health centres (IHC). The switch also changed district level storage utilization from a mean of 65% to means of 64%, 66% and 68% (range for all scenarios: 3-100%). Finally, accounting for vaccine administration, wastage, and disposal, replacing the 10-dose vial with the 5 or 1-dose vials would increase the cost per immunized patient from $0.47US to $0.71US and $1.26US, respectively.ConclusionsThe switch from the 10-dose measles vaccines to smaller vial sizes could overwhelm the capacities of many storage facilities and transport vehicles as well as increase the cost per vaccinated child.

【 授权许可】

Unknown   
© Assi et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.