Post00349 : VACCINE WASTAGE

Post00349 VACCINE WASTAGE 13 June 2001 CONTENTS 1. VACCINE WASTAGE Continued In Technet Post00345, 05 June 2001, Samir J Shah, MOH/Oman, kindly posted his observations and questions on vaccine wastage in his region of Oman. His original message is re-posted below. In todays posting Julie Milstien, WHO/V&B/ATT, discusses and explains some of the issues raised and seeks clarification of the wastage figures reported. Samir replies with clarifications. * The sharing of field data, experience and discussions on vaccine wastage is useful to all of us. Please send your contribution to: [log in to unmask] or use your reply button ___________________________________________________________________________ From: [log in to unmask] Date: Tue, 5 Jun 2001 Subject: RE: VACCINE WASTAGE To: Technet Moderator I can contribute a small amount to this, but first I would like to thank Dr Shah for making this information available. We would really like to have information such as this from more programmes. We would be particularly interested in studies with liquid vaccines, with and without implementation of the multi-dose vial policy. Is the MDVP used in Oman? There are 2 points about BCG vaccine. The first is that the vaccine is so cheap compared to the vials and packaging that it is actually more economical to buy 20 dose vials and waste 11 doses than to buy 10 dose vials (which don't exist at this point). But the question raised, as I understand it, is that there were actually only 8-9 doses in a vial labeled 20 doses. We requested the manufacturers to clarify the labeling a few years ago because of confusion, so that now 20 dose vials should refer to 20 INFANT (0.05 ml) doses. If it is being used for children, at a dose of 0.1 ml (not recommended by WHO in the standard immunization schedule), then a 20 dose vial would of course contain only 10 doses. Re the measles vaccine, MMR vaccines in monodose presentation will of course be much more expensive, though maybe it is a cost effective change - provided the programmatic feasibility and the recommendations for use of rubella are carefully taken into account. However, both the proposed changes - a change to MMR from measles, and a change to a monodose presentation - will have profound impact on the overall global capacity for measles vaccine if they are widely implemented. Re the liquid vaccines, is the wastage figure 1-1.3, or 1-1.4, or 1.34? I could not understand the figure? Thanks for the report. Julie Milstien Dr Julie Milstien Coordinator, Access to Technologies Department of Vaccines and Biologicals World Health Organization 20 Ave Appia Room M231 1211 Geneva 27 Switzerland tel 41 22 791 3564 fax 41 22 791 4384 email [log in to unmask] --- From: "Dr.Samir Shah" To: Technet Moderator Cc: Subject: RE: VACCINE WASTAGE Date: Tue, 12 Jun 2001 Dear Allen/Julie, MDVP is practised in Oman. Wastage factor for other vaccines I meant was between 1 to 1.3. Once I get the permission (and data are in final shape) I to share the actual data with you. I hope this clarifies the matter. Thanks for your comments. Regards, Dr.Samir J Shah Oman ___________________________________________________________________________ From: "Dr.Samir Shah" To: Subject: Vaccine Wastage. Inviting comments and looking for references. Date: Mon, 21 May 2001 1 Dear Allan, I am Dr.Samir J Shah working as Regional Epidemiologist in Oman. Well TECHNET group discussion on vaccine wastage inspired me and hence I am doing a study for estimation of vaccine wastage in the region (like state or province). Vaccination coverage for ALL childhood immunization is 100%. Calculation of Vaccine wastage factor is done by using formula ={(Doses remained at the end of previous year + Total doses issued in the current year) - Balance of doses at the end of the current year}/ Total doses administered to children in the current year. Initial findings suggest Vaccine wastage factor in tune of 4 or higher in BCG (20 dose vial) and Measles (5 and 10 dose vial). My questions/ points for the discussion for the TECHNET group is as follows, 1) We are able to vaccinate 8 to 9 children ONLY from the 20-dose BCG vaccine vial, even when 20 children available at a point. (Mfg. Japan BCG lab. Tokyo). Is it the routine or we are lacking on our part somewhere? 2) For Measles it is largely opportunity wastage and hence I am planning to suggest that we may need to evaluate the option of giving MMR vaccine (mono dose) instead. I need to explore the cost of mono dose of MMR vaccine and its benefits versus 4 dose of measles vaccine. We are giving Measles at 9 months and MMR at 15 months. It will be ideal if we can shift the "proposed" MMR instead of 9 months to 1 year. I am waiting for your suggestions. 3) For all other vaccines, wastage factor is around 1 to 1.3. 4) I need references of similar studies made elsewhere in other countries AND other literature available on the subject. Thanks for your suggestions in advance. Regards and best wishes, Dr.Samir J Shah. ___________________________________________________________________________ RECENT TECHNET POSTINGS ON VACCINE WASTAGE WERE: Post00311 ESTIMATING VACCINE WASTAGE FACTORS 16/1/2001 Post00316 ESTIMATING WASTAGE FACTORS 29/1/2001 Post00320 WASTAGE FACTORS Continued PLUS! 13/2/2001 Post00324 VACCINE VOLUME IMPACT CALCULATOR 27/2/2001 Post00345 VACCINE WASTAGE 5/6/2001 ____________________________________*______________________________________ ____________________________________*______________________________________