POST 00433E: IMPACT OF VVMs ON THE USE and DELIVERY OF MEASLES VACCINE

POST 00433E: IMPACT OF VACCINE VIAL MONITORS (VVM) ON THE USE and DELIVERY OF MEASLES VACCINE 5 MARCH 2002 __________________________________________________________ Umit Kartoglu, WHO/Vaccine and Biologicals/Access to Technologies informs us with a recently planned VVM impact study on the use and delivery of measles vaccine in Vietnam. The study protocol is jointly developed by the Ministry of Health, WHOHQ/ATT, WHO/WPRO and WHO Vietnam country office in coordination with PATH. In 1999, a pilot measles campaign was conducted in Hai Phong city targeting 327,700 children of 9 months to 10 years of age and achieved 99% coverage. Following year the campaign was targeting 1,555,000 children in Ha Noi, Thua Thien Hue, Da Nang, Ba Ria Vung Tau, Can Tho and in one district each in Hao Binh and Dac Lac provinces. 2000 campaign achieved 98% coverage. As for 2002, 8,5000,000 children are targeted in 28 northern provinces from Ha Tinh north. Following plans for Vietnam includes to cover 33 southern provinces in 2003 targeting 11,500,000 children and introduction of the second dose measles vaccine in routine programme in 2005. The campaigns to date have used measles vaccine from UN prequalified vaccine manufacturers. No vaccine vial monitors for measles vaccine have been used in Vietnam previously. Although experience in using oral polio vaccine with vaccine vial monitors during national and sub-national immunization days in Vietnam is limited to Phu Tho province in 1997, extensive training activities have been planned for areas using VVM on measles. Vietnam already received 1,607,000 doses of measles vaccine in 10-dose vials with VVMs attached (from Chiron) and 9,284,900 doses of measles vaccines in 10-dose vials without VVMs (from Aventis Pasteur). All vaccines are donated by JICA. Having the same vaccine with and without VVMs created a perfect opportunity for a study to document the experience. The overall goal of the study is to increase safety and efficiency of measles vaccine administration. Specific objectives are: 1. To evaluate health, financial and logistics impact of use of vaccine vial monitors (VVM) on measles vaccine in a campaign setting. 2. To identify actions needed to further enhance the effectiveness of VVM use. The first evaluation objective involves trying to quantify the positive and negative impacts. This will be tested in two different settings: typical settings with no special efforts except planned campaign training and "best-case" settings with special efforts on introduction of VVM through specific training and follow-up supervision. The second evaluation objective is action-oriented, analyzing which strategies have been particularly successful or where specific weaknesses exist which need to be remedied. Following hypothesis are made to be tested: 1. Health workers who handle the measles vaccine (receive and distribute) feel more confident with vials VVMs attached. 2. Health workers using the measles vaccine (administrating) feel more confident with vials VVMs attached. 3. Health workers at all levels who manage the measles vaccine can easily read and interpret the VVMs to make managerial decisions. 4. VVM can be used effectively in increasing access to target population in remote areas and in locations with weak cold chain. Selection of the area for use of measles vaccine with VVM was made on the basis of the combination of following criteria: * Hard-to-reach areas with access problems * Locations with weak cold chain For comparison reasons, a control area was defined where vaccine without VVM will be in use. All staff involved in the study who will be handling measles vaccine with VVMs will be trained on the following areas using newly updated VVM training guidelines from WHO and PATH VVM training cards: * Read and interpret VVMs * Use vaccines with higher readings of VVM (but before it reaches its discard point) first (if the vaccine will be used quickly) * Discard VVM during reconstitution * Discard reconstituted measles vaccine within 6 hours or at the end of the session whichever comes first No special training (besides planned training for measles campaign) will be given to control site. A KAP survey will also be conducted both in study and control sites. The 2002 measles campaign will start in mid-March. FOOTNOTE >>>> VVM on freeze-dried vaccine is placed either on the cap or on the neck of the ampoule depending on the presentation. This is to facilitate the discard of VVM during reconstitution (by opening the cap or breaking the neck of the ampoule). Because, reconstituted vaccines must be discarded within 6 hours or at the end of the session whichever comes first (and therefore VVM after reconstitution should not be referred). ----------------------------------------------------------------------------- CONTRIBUTIONS: Contributions to: or use your reply button! The TechNet21 e-Forum welcomes new subscribers who are involved in immunization services. SUBCRIBE: To subscribe, send an e-mail to: Leave the SUBJECT area BLANK, do not type anything. In the body text, just write: Subscribe TECHNET21E Surname Name Do not use any accents in your name and surname. UNSUBSCRIBE: To unsubscribe, send an e-mail to: Leave the SUBJECT area BLANK, do not type anything. In the body text, just write: Unsubscribe TECHNET21E ------------------------------------------------------------------------------ ARCHIVES New archives of posted messages starting with 1 November 2001 is accessible to all TechNet21 subscribers. 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