Dose Per Container: Understanding the Effects of Multidose Vaccine Presentations

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The widespread use of multi-dose vaccine containers in low- and middle-income countries’ immunization programs is assumed to offer benefits and efficiencies for health systems, such as reducing the purchase price per vaccine dose and easing cold chain requirements. Yet the broader impacts on immunization coverage, costs, and safety are not well understood. It is also unclear what processes governments typically go through to determine their choices about dose per container (DPC), and what information decision-makers have or use when determining DPC. To add to the limited evidence base on this topic, the JSI-led Dose Per Container Partnership (DPCP), funded by the Bill & Melinda Gates Foundation, with partners Clinton Health Access Initiative (CHAI), the HERMES modeling team and the International Vaccine Access Center (IVAC) through Johns Hopkins University, Bloomberg School of Public Health, and PATH, undertook a series of activities to explore current decision-making on DPC options and better understand the relationship between DPC and immunization systems, including operational costs, timely coverage, safety, product costs/wastage, and policy/correct use.

Watch our video, explore the resources below and share your thoughts with us on DPC. 

  • Case studies - A series of case studies on DPCP's implemented country-level research, decision making on DPC options, computer simulation modeling, and a review of tools on DPC.
  • Decision support resources - Resources that provide decision makers with evidence that can be generalized to help make effective DPC decisions based on country context. Country- and global-level stakeholders — such as Expanded Program on Immunization (EPI) managers, logisticians, Ministries of Health (MOHs), Ministries of Finance (MOFs), donors, procurement agencies, manufacturers, global partners, and other stakeholders — can use these resources to better understand the potential trade-offs of various DPC choices and to select the best vaccine presentations for their program. 

  

 Case studies

Title Author Year Type Language
Vietnam: Effects of Changing Dose per Container on the Immunization System Dose Per Container Partnership 2018 Document English
Vaccination in Zambia - Healthworker Experiences Using 5-dose MR Vaccine Dose Per Container Partnership 2018 Document English
Senegal: Weighing the Costs and Benefits of Changing DPC Dose Per Container Partnership 2018 Document English
Modeling to Support Decision-Making for 5-dose Measles-Rubella Routine Vaccination in Zambia Dose Per Container Partnership 2018 Document English
Measles Vaccination in Zambia: Balancing Coverage & Wastage Dose Per Container Partnership 2018 Document English
Information Gaps in Decision-Making on Vaccine Presentation in 3 Francophone Countries Dose Per Container Partnership 2017 Document English
Immunization Tools to Help the Dose Per Container Decision Dose Per Container Partnership 2018 Document English
Ghana: Understanding Changes in Vaccine Presentation Dose Per Container Partnership 2018 Document English

 

Decision support resources

Title Author Year Type Language
Introducing the Measles and Measles-Rubella (MR) Vaccine Five-dose vial Presentations Facts Sheet UNICEF 2019 Document English
Vaccine Dose Per Container: Deciding What's Right for Your Immunization Program Dose Per Container Partnership 2019 Document English
Immunization Dose Per Container: Decision Support Resource Dose Per Container Partnership 2019 Document English