Dose Per Container: Understanding the Effects of Multidose Vaccine Presentations

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

Decision support resources