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

Assi, TM and Brown, ST and Djibo, A and Norman, BA and Rajgopal, J and Welling, JS and Chen, SI and Bailey, RR and Kone, S and Kenea, H and Connor, DL and Wateska, AR and Jana, A and Wisniewski, SR and Van Panhuis, WG and Burke, DS and Lee, BY (2011) Impact of changing the measles vaccine vial size on Niger's vaccine supply chain: A computational model. BMC Public Health, 11.

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Background: Many 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. Methods. We 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. Results: Switching 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. Conclusions: The 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. © 2011 Assi et al; licensee BioMed Central Ltd.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Assi, TM
Brown, ST
Djibo, A
Norman, BAbanorman@pitt.eduBANORMAN
Rajgopal, Jj.rajgopal@pitt.eduGUNNER10000-0001-7730-8749
Welling, JS
Chen, SI
Bailey, RR
Kone, S
Kenea, H
Connor, DL
Wateska, AR
Jana, A
Wisniewski, SRSTEVEWIS@pitt.eduSTEVEWIS
Van Panhuis, WGwilbert.van.panhuis@pitt.eduWAV10
Burke, DSdonburke@pitt.eduDONBURKE
Lee, BYbyl1@pitt.eduBYL1
Centers: Other Centers, Institutes, Offices, or Units > Center for Vaccine Research
Date: 6 June 2011
Date Type: Publication
Journal or Publication Title: BMC Public Health
Volume: 11
DOI or Unique Handle: 10.1186/1471-2458-11-425
Schools and Programs: Graduate School of Public Health > Epidemiology
Refereed: Yes
Date Deposited: 07 May 2015 19:26
Last Modified: 11 May 2021 11:56


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