Article de revue
The effects of switching from 10 to 5-dose vials of MR vaccine on vaccination coverage and wastage: A mixed-method study in Zambia
Abstract
Introduction
Vaccines procured for low-income countries are often packaged in multi-dose vials to reduce program costs. To avoid wastage, health workers may refrain from opening a vial if few children attend an immunization session, possibly leading to lower coverage. Lowering the number of doses in a vial may increase coverage and reduce wastage.
Methods
We used a mixed methods approach to measure the effects of switching from conventional 10-dose measles containing vaccine (MCV) vials to 5-dose MCV vials on coverage and open vial wastage in 14 districts purposely selected from two provinces in Zambia. The districts were paired based on the number of health facilities and the average size of the health facility catchment population. One district from each pair was randomly allocated to receive 5-dose vials while the other continued with the conventional vials. We applied propensity score matched difference-in-difference analysis to estimate intervention effects on coverage using pre-intervention household survey and post-intervention household survey after 11 months of the intervention. The intervention effects on wastage rates were estimated from multivariate analysis of the administrative data. Key informant interviews were conducted to better understand health workers’ behavior and preferences at baseline, midline and endline, and analyzed using thematic analysis techniques.
Results
MCV coverage rates increased across both arms for both doses. A five percentage-point intervention effect was detected for MCV1 and 3.5 percentage-point effect for MCV2. The MCV wastage rate was 47% lower in facilities using 5-dose vials (16.2%) versus 10-dose vials (30.5%). Healthcare workers reported being more willing to open a 5-dose vial than a 10-dose vial for one child, as they were less concerned about wastage.
Discussion
Switching 10-dose MCV vials to 5-dose vials improved coverage, decreased wastage, and improved willingness to open a vial. These findings can contribute to strategies for reducing missed opportunities for vaccination.
Auteurs
Langues
- Anglais
Année de publication
2020
Journal
Vaccine
Volume
37
Type
Article de revue
Catégories
- Vaccins et dispositifs d'administration
Maladies
- Rougeole
Régions de l'OMS
- Région africaine
Références sur le sujet
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Economic Implications of Switching Rotavirus Vaccine Products in Palestine's Immunization Program | PATH | 2020 | Case study | Russe |
Introducing 5-dose Measles-Rubella Vaccine Vials in Zambia: Research Findings | Dose Per Container Partnership | 2019 | Case study | Anglais |
The effects of switching from 10 to 5-dose vials of MR vaccine on vaccination coverage and wastage: A mixed-method study in Zambia | Ali Karim, Barbara Knittel, Frances Mwansa, Guissimon Phiri, Kirstin Krudwig, Natasha Kanagat, Robert Steinglass, Wendy Prosser | 2020 | Journal article | Anglais |
The Health Benefits of Rotavirus Immunization for Children in Palestine: Results of a Vaccine Impact Analysis | PATH, Rostropovich-Vishnevskaya Foundation, Ministry of Health, Palestine | 2021 | Report | Russe |
The switch from ROTARIX to ROTAVAC in Ghana: Answers to four key questions | PATH | 2022 | Report | Anglais |