{"text_format":"1","workbook":"xlsx","n_sheets":10,"sheets":["READ ME FIRST","Inputs","Results","Impact","Coverage Data","Country Data","Wastage Data","Program Costs","Product Data","Gavi co-financing"],"not_rendered":{"charts":5,"images":2,"macros":1,"external_links":0,"defined_names":2,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"READ ME FIRST","index":0,"n_rows":65,"n_cols":6,"rows_kept":65,"cut":false,"hidden":false,"merged":[[12,1,12,6],[4,1,4,6],[38,1,38,6],[17,1,18,1],[17,2,18,4],[18,5,18,6],[19,2,19,4],[28,2,28,6],[29,2,29,6],[30,2,30,6],[17,5,17,6],[19,5,19,6],[20,5,20,6],[27,2,27,6],[33,1,33,6],[20,1,21,1],[1,1,1,6],[2,1,2,6],[10,1,10,6],[6,1,6,6],[8,1,8,6],[21,5,21,6],[20,2,21,4],[23,1,23,6],[25,1,25,6],[52,2,52,4],[41,5,41,6],[35,1,35,6],[40,5,40,6],[41,1,42,1],[41,2,42,4],[40,2,40,4],[42,5,42,6],[14,2,14,4],[14,5,14,6],[15,2,15,4],[16,2,16,4],[15,5,15,6],[16,5,16,6],[64,2,64,6],[60,2,60,6],[57,1,57,6],[54,2,54,4],[47,5,47,6],[48,5,48,6],[53,5,53,6],[54,5,54,6],[49,5,49,6],[48,2,48,4],[53,2,53,4],[61,2,61,6],[62,2,62,6],[50,5,50,6],[55,2,55,4],[55,5,55,6],[63,2,63,6],[43,2,43,4],[43,5,43,6],[51,2,51,4],[51,5,51,6],[49,2,49,4],[46,5,46,6],[44,2,44,4],[45,2,45,4],[46,2,46,4],[47,2,47,4],[45,5,45,6],[59,2,59,6],[50,2,50,4],[52,5,52,6],[44,5,44,6]]}
[null,"MCV 5-Dose Vial Assessment Support Tool"]
[null,"For questions or support, contact Linksbridge's MCV 5-dose team: lena.stashko@linksbridge.com; sheldon.halsted@linksbridge.com; and/or maggie.archbold@linksbridge.com"]
[null,"Overview"]
[]
[null,"The MCV 5-dose assessment support tool is a simple model for assessing and comparing the programmatic, financial, and logistical trade-offs between 5-dose and 10-dose MCV vials. It aims to help country-level decision-makers compare products and estimate its impact on coverage, total systems cost, and cold chain requirements. The tool can be used by any country interested in comparing MCV 10-dose and 5-dose products. "]
[]
[null,"Disclaimer: The MCV 5-dose assessment support tool aims to inform vaccine product selection. Please note that there is limited data available on the impact of MCV 5-dose vials on wastage rates, coverage, and costs; adjust the inputs as needed to account for this uncertainty. This model is meant to provide insights into the potential impact of transitioning to 5-dose vials and should not replace detailed forecasting or operational and budget planning. "]
[]
[null,"User Guide"]
[]
[null,"Inputs"]
[]
[null,"In the Inputs worksheet, you can select your country to model for and which vaccines to compare, and can adjust assumptions around coverage, wastage, and costs."]
[]
[null,"Category","Description",null,null,"Sources"]
[null,"Country","• Lets you select the country being analyzed and autopopulates target population size\n• You can also ene",null,null,"UNPD 2022 Revision, birth cohort size in 2022, autopopulated for the country listed as the reference"]
[null,"Coverage","• Coverage is autopopulated based on WUENIC Coverage estimates for MCV1 and MCV2 in 2021\n• We modeled the intervention effect across different baseline MCV1 and MCV2 coverage rates\n• We applied the intervention effect (+ 4.9% for MCV1, + 3.5% for MCV2) to baseline coverage up to 82.1% for MCV1 and 43.0% for MCV2\n• Beyond the baseline coverage found in the Zambia study, we assumed diminishing returns, with eventually no intervention effect once baseline coverage reaches 95%\n• As baseline MCV coverage increases, the impact of switching to 5-dose vials on coverage decreases",null,null,"WUENIC 2022 data, coverage in 2021 autopopulated for the country listed as the reference"]
[null,"Wastage","• Given the uncertainty of the impact of 5-dose vials on wastage, and the various factors that influence wastage, this analysis allows you to select from two different sources for wastage assumptions:\n1) The WHO/UNICEF Measles and Measles-Rubella (MR) Vaccine Five-Dose Vial Presentations Facts Sheet 2021\n2) The results from the Zambia study (Krudwig et al., 2020)",null,null,"WHO/UNICEF wastage"]
[null,null,null,null,null,"Zambia coverage and wastage study"]
[null,"Program Costs","• The additional annual financial and economic costs per dose administered associated with switching from 10-dose to 5-dose vials\n• Additional costs take into account cold chain, transport, outreach, human resources, and wastage disposal costs\n• Data came from the Zambia study",null,null,"Zambia 5-dose vial coverage and wastage study"]
[null,"Vaccine Costs & Cold Chain","• Lets you compare the current 10-dose product, as well as first and second options for switching to 5-dose vials \n• Different options have different prices and cold chain requirements",null,null,"Price: UNICEF M/MR vaccine prices"]
[null,null,null,null,null,"Cold chain: Gavi Detailed Product Profiles"]
[]
[null,"Results"]
[]
[null,"The Results worksheet shows a comparison of 5- and 10-dose vials in terms of vaccine delivery, total systems costs, cold chain requirements, and additional considerations."]
[]
[null,"Category","Description"]
[null,"Vaccine Delivery","Shows the impact of switching to 5-dose vials on total required supply, doses administered, and doses wasted."]
[null,"Total Systems Costs","Shows the impact of switching to 5-dose vials on vaccine procurement cost and total cost per vaccinated child – and also for the entire country, Gavi, and the total."]
[null,"Cold Chain Requirements","Shows the wastage-adjusted cold chain volume per dose administered and for the entire country."]
[]
[]
[null,"Impact"]
[]
[null,"The Impact worksheet is a high-level summary comparing the impact of 5-dose vials on the countries' vaccine delivery program, costs, and cold-chain, as well as additional considerations."]
[]
[]
[null,"Glossary & Calculations"]
[]
[null,"Category","Description",null,null,"Calculation"]
[null,"Number of doses administered","The number of M and MR doses administered to children, including both MCV1 and MCV2 doses",null,null,"10-dose vial: (target population * MCV1 coverage) + (target population * MCV2 coverage)"]
[null,null,null,null,null,"5-dose vial: (target population * (MCV1 coverage + increase in MCV1 coverage)) + (target population * (MCV2 coverage + increase in MCV2 coverage))"]
[null,"Total required supply","The demand for M and MR, considering target population, number of doses, coverage, and wastage rate",null,null,"Number of doses administered * wastage factor [1 / (1 – vial-size wastage)]"]
[null,"Number of doses wasted","The number of doses wasted out of the total required supply, based on the wastage rates",null,null,"Total required supply – number of doses administered"]
[null,"Vaccine price","The vaccine price per dose, as reported by UNICEF",null,null,"No calculation (input)"]
[null,"Vaccine procurement cost per vaccinated child","The vaccine cost per dose administered, adjusted for wastage",null,null,"Vaccine price * (total required supply / number of doses administered)"]
[null,"Incremental non-vaccine costs per vaccinated child","The additional annual costs per dose administered associated with switching from 10-dose to 5-dose vials. Additional costs take into account cold chain, transport, outreach, human resources, and wastage disposal costs.",null,null,"No calculation (input)"]
[null,"Total costs per vaccinated child","The wastage-adjusted vaccine procurement cost per vaccinated child. For 5-dose vials, this also includes the incremental non-vaccine costs per vaccinated child.",null,null,"5-dose vial: Vaccine procurement cost per vaccinated child + incremental non-vaccine costs per vaccinated child"]
[null,"Total vaccine procurement costs for country","The total vaccine procurement costs for the country",null,null,"Vaccine price * total required supply * country co-financing share"]
[null,"Total vaccine procurement costs for Gavi","The total vaccine procurement costs for Gavi, if Gavi co-finances",null,null,"Vaccine price * total required supply * Gavi co-financing share"]
[null,"Total vaccination program costs for country","The total vaccine procurement costs for the country. For 5-dose vials, this also includes the incremental non-vaccine costs associated with switching from 10- to 5-dose vials",null,null,"5-dose vial: (Vaccine price * total required supply * conutry co-financing share) + (number of doses administered * incremental non-vaccine costs per vaccinated child)"]
[null,"Total vaccination program costs (including Gavi procurement cost)","The total vaccine procurement costs to country and Gavi and the incremental programmatic costs for 5-dose vials.",null,null,"5-dose vial: (Vaccine price * total required supply) + (number of doses administered * incremental non-vaccine costs per vaccinated child)"]
[null,"Cold chain volume per dose","Cold chain volume required per dose (in cm3) from the Gavi detailed product profiles",null,null,"No calculation (input)"]
[null,"Total vaccine cold chain volume in country","Cold chain volume per dose administered, adjusted for wastage",null,null,"Total vaccine cold chain required in country (cold chain volume per dose * total required supply)"]
[null,"Net storage per dose","Cold chain volume per dose administered, adjusted for wastage",null,null,"The Zambia study looked at the net storage required per fully immunized child, considering cold boxes, vaccine carriers, and refrigerators"]
[]
[null,"Limitations"]
[]
[null,"Limitation","Description"]
[null,"Wastage","• Limited data is available on the impact of MCV 5-dose vials on wastage rates\n• Many factors can influence wastage, and the context of each country should be taken into consideration"]
[null,"Coverage","• Limited data is available to understand the impact of 5-dose vials on coverage in different settings, such as healthcare facilities with varying catchment population sizes"]
[null,"Total Costs","• There is uncertainty around the incremental programmatic costs associated with switching to 5-dose vials, and costs will vary in different contexts"]
[null,"Cold Chain","• The impact of switching to 5-dose vials on the cold chain is uncertain and will vary for each healthcare facility"]
[null,"Zambia Study","• The Zambia study was used to inform assumptions on wastage, coverage, incremental costs, and cold chain\n• Please reference the Zambia study (see Inputs section, above) for a complete description of study limitations"]

{"sheet":"Inputs","index":1,"n_rows":37,"n_cols":9,"rows_kept":37,"cut":false,"hidden":false,"merged":[[6,8,6,9],[7,8,7,9],[5,8,5,9],[8,8,8,9],[9,8,9,9],[26,4,26,6],[11,1,11,6],[1,1,1,6],[24,1,24,6],[20,4,20,6],[21,4,21,6],[22,4,22,6],[2,1,2,6],[6,4,6,6],[7,4,7,6],[4,1,4,6],[16,4,16,6],[9,4,9,6],[8,4,8,6],[2,8,2,9],[39,1,39,9],[39,11,39,20],[36,8,36,9],[29,11,29,20],[31,11,31,20],[33,8,34,9],[35,8,35,9],[33,11,33,12],[29,1,29,9],[31,1,31,9],[27,4,27,6],[13,4,13,6],[14,4,14,6],[15,4,15,6],[18,1,18,6]]}
[null,"MCV 5-Dose Vial Assessment Support Tool - Inputs"]
[null,"For questions or support, contact Linksbridge's MCV 5-dose team: lena.stashko@linksbridge.com; sheldon.halsted@linksbridge.com; and/or maggie.archbold@linksbridge.com"]
[null,"STEP 1: IMMUNIZATION PROGRAM"]
[]
[null,"Country"]
[null,null,null,null,null,null,null,null,"Legend:"]
[null,"Select country >>>","Indonesia",null,"Country being analyzed",null,null,null,"REQUIRED: Select input from drop-down menu."]
[null,"Target population size",{"$f":"VLOOKUP($C$7,'Country Data'!$B$3:$E$196,4,FALSE)","v":4435250},null,"UNPD 2022 Revision, birth cohort size in 2022, autopopulated for the country listed as the reference",null,null,null,"Autopopulated data based on selected inputs or pre-populated data. These cells can be overwritten if you want to enter your own inputs. "]
[null,"Gavi co-financing status","Preparatory transition",null,"Country's Gavi co-financing status in the year being analyzed",null,null,null,"Inputs that have been manually entered are highlighted in yellow. "]
[null,"Country co-financing share",1,null,"The country's percent of vaccine price per dose or \"price fraction\" that they are responsible for. Non-Gavi countries should enter 100% for all years,",null,null,null,"WARNING: If you manually adjust an input cell, click the RESET button if you want to return to autopopulated data."]
[]
[null,"Coverage"]
[]
[null,"MCV1 coverage",{"$f":"VLOOKUP($C$7,'Country Data'!$B$3:$D$196,2,FALSE)","v":0.72},null,"WUENIC 2022 data, MCV1 coverage in 2021, autopopulated for the country listed as the reference"]
[null,"MCV2 coverage",{"$f":"VLOOKUP($C$7,'Country Data'!$B$3:$D$196,3,FALSE)","v":0.5},null,"WUENIC 2022 data, MCV2 coverage in 2021, autopopulated for the country listed as the reference"]
[null,"Increase in MCV1 coverage",{"$f":"_xlfn.IFNA(VLOOKUP($C$14,Table14[],2,FALSE),0)","v":4.9000000000000002E-2},null,"Expected increase in MCV1 coverage by switching to 5-dose vials"]
[null,"Increase in MCV2 coverage",{"$f":"_xlfn.IFNA(VLOOKUP(C$15,Table14[],3,FALSE),0)","v":3.0244999999999966E-2},null,"Expected increase in MCV2 coverage by switching to 5-dose vials"]
[]
[null,"Wastage"]
[]
[null,"Select wastage assumption source  >>>","Zambia Study",null,"Given the uncertainty of the impact of 5-dose vials on wastage, and the various factors that influence wastage, you can select wastage assumptions from the WHO/UNICEF fact sheet, from the Zambia study results, or enter your own wastage assumptions."]
[null,"10-dose vial wastage",{"$f":"VLOOKUP(C$21,Table5[],2,FALSE)","v":0.30530000000000002},null,{"$f":"VLOOKUP(C$21,'Wastage Data'!$A$3:$D$5,4,FALSE)","v":"Wastage results from the Zambia study"}]
[null,"5-dose vial wastage",{"$f":"VLOOKUP(C$21,Table5[],3,FALSE)","v":0.1618},null,{"$f":"VLOOKUP(C$21,'Wastage Data'!$A$3:$D$5,4,FALSE)","v":"Wastage results from the Zambia study"}]
[]
[null,"Program Costs"]
[]
[null,"Select program costs source  >>>","Zambia Study",null,"The additional, non-vaccine annual costs per dose administered associated with switching from 10-dose to 5-dose vials. Given the uncertainty of the impact of 5-dose vials on programmatic costs, you can select cost assumptions from the Zambia study results or enter your own assumptions."]
[null,"Incremental non-vaccine costs per 5-dose vial administered",{"$f":"VLOOKUP(C27,Table55[],2,FALSE)","v":0.11},null,{"$f":"VLOOKUP(C27,'Program Costs'!A3:C4,3,FALSE)","v":"The Zambia study found that the incremental economic and financial cost per 5-dose vial administered was $0.11 (excluding the cost of the vaccine). Additional costs take into account cold chain, transport, outreach, human resources, and wastage disposal costs. Data came from the DPCP Zambia report."}]
[]
[null,"STEP 2: MEASLES-CONTAINING VACCINE OPTIONS"]
[]
[null,"Vaccines Costs & Cold Chain"]
[]
[null,null,"CURRENT 10-DOSE VIAL PRODUCT",null,"OPTION 1\n(5-DOSE VIAL)",null,"OPTION 2\n(5-DOSE VIAL)",null,"COMMENTS AND SOURCES"]
[null,"Select vaccine and presentation >>>","Measles, SII\n 10-dose vial",null,"Measles, SII\n 5-dose vial",null,"Measles, SII\n 5-dose vial"]
[null,"Price per dose",{"$f":"VLOOKUP(C$35,Table2[],2,FALSE)","v":0.42299999999999999},null,{"$f":"VLOOKUP(E$35,Table2[],2,FALSE)","v":0.52200000000000002},null,{"$f":"VLOOKUP(G$35,Table2[],2,FALSE)","v":0.52200000000000002},null,"From UNICEF vaccines pricing data, or can manually enter"]
[null,"Cold chain volume per dose (cm3)",{"$f":"VLOOKUP(C$35,Table2[],3,FALSE)","v":5.25},null,{"$f":"VLOOKUP(E$35,Table2[],3,FALSE)","v":8.64},null,{"$f":"VLOOKUP(G$35,Table2[],3,FALSE)","v":8.64},null,"Cold chain volume required per dose (in cm3) from the Gavi Detailed Product Profiles (includes vial and ampoule)"]

{"sheet":"Results","index":2,"n_rows":48,"n_cols":28,"rows_kept":48,"cut":false,"hidden":false,"merged":[[44,1,44,2],[39,1,39,2],[40,1,40,2],[41,1,41,2],[42,1,42,2],[43,1,43,2],[21,1,21,2],[28,1,30,1],[33,11,33,12],[33,14,33,15],[32,1,33,1],[29,11,29,12],[29,14,29,15],[30,11,30,12],[30,14,30,15],[7,1,7,2],[8,1,8,2],[9,1,9,2],[10,1,10,2],[11,1,11,2],[38,14,40,15],[39,8,39,9],[39,5,39,6],[38,8,38,9],[23,1,23,15],[38,5,38,6],[38,11,40,12],[25,5,25,6],[25,8,25,9],[25,11,27,12],[25,14,27,15],[26,1,26,2],[26,5,26,6],[26,8,26,9],[27,1,27,2],[47,1,47,15],[16,5,16,6],[6,8,6,9],[7,8,7,9],[16,8,16,9],[17,5,17,6],[17,8,17,9],[43,11,43,12],[43,14,43,15],[44,11,44,12],[44,14,44,15],[28,11,28,12],[28,14,28,15],[41,11,41,12],[41,14,41,15],[42,11,42,12],[42,14,42,15],[31,11,31,12],[31,14,31,15],[1,1,1,8],[10,11,10,12],[11,11,11,12],[9,14,9,15],[10,14,10,15],[11,14,11,15],[9,11,9,12],[2,1,2,15],[4,1,4,15],[6,5,6,6],[7,5,7,6],[6,11,8,12],[6,14,8,15],[14,1,14,15],[32,11,32,12],[32,14,32,15],[36,1,36,15],[21,11,21,12],[21,14,21,15],[19,11,19,12],[19,14,19,15],[20,11,20,12],[20,14,20,15],[16,11,18,12],[16,14,18,15],[17,1,17,2],[18,1,18,2],[19,1,19,2],[20,1,20,2]]}
[null,"MCV 5-Dose Vial Decision Support Tool - Results (annual)"]
[null,"For questions or support, contact Linksbridge's MCV 5-dose team: lena.stashko@linksbridge.com; sheldon.halsted@linksbridge.com; and/or maggie.archbold@linksbridge.com"]
[null,{"$f":"_xlfn.CONCAT(\"OUTPUTS: \",UPPER(Inputs!C7))","v":"OUTPUTS: INDONESIA"}]
[]
[null,"VACCINE DELIVERY"]
[]
[null,null,null,"CURRENT 10-DOSE VIAL PRODUCT",null,"OPTION 1\n(5-DOSE VIAL)",null,null,"OPTION 2\n(5-DOSE VIAL)",null,null,"Description",null,null,"Interpretation"]
[null,"Vaccine and presentation",null,{"$f":"Inputs!$C$35","v":"Measles, SII\n 10-dose vial"},null,{"$f":"Inputs!$E$35","v":"Measles, SII\n 5-dose vial"},null,null,{"$f":"Inputs!$G$35","v":"Measles, SII\n 5-dose vial"}]
[null,"Output and difference",null,"Output",null,"Output","Difference (5d minus 10d)",null,"Output","Difference (5d minus 10d)"]
[null,"Total required supply",null,{"$f":"(Inputs!$C$8*Inputs!$C$14*(1/(1-Inputs!$C$22)))+(Inputs!$C$8*Inputs!$C$15*(1/(1-Inputs!$C$22)))","v":7788980.8550453447},null,{"$f":"(Inputs!$C$8*(Inputs!$C$14+Inputs!$C$16)*(1/(1-Inputs!$C$23)))+(Inputs!$C$8*(Inputs!$C$15+Inputs!$C$17)*(1/(1-Inputs!$C$23)))","v":6874822.6989382003},{"$f":"F10-D10","v":-914158.15610714443},null,{"$f":"(Inputs!$C$8*(Inputs!$C$14+Inputs!$C$16)*(1/(1-Inputs!$C$23)))+(Inputs!$C$8*(Inputs!$C$15+Inputs!$C$17)*(1/(1-Inputs!$C$23)))","v":6874822.6989382003},{"$f":"I10-D10","v":-914158.15610714443},null,"The demand for MCV considering target population, number of doses, coverage, and wastage rates",null,null,{"$f":"(_xlfn.CONCAT(\"The total required supply will reduce by \",TEXT(ABS(D10-F10),\"###,###,###\"),\" doses annually, or by \",TEXT(ABS(((D10-F10)/D10)),\"0%\")))","v":"The total required supply will reduce by 914,158 doses annually, or by 12%"}]
[null,"Number of doses administered",null,{"$f":"(Inputs!$C$8*Inputs!$C$14)+(Inputs!$C$8*Inputs!$C$15)","v":5411005},null,{"$f":"(Inputs!$C$8*(Inputs!$C$14+Inputs!$C$16))+(Inputs!$C$8*(Inputs!$C$15+Inputs!$C$17))","v":5762476.3862500004},{"$f":"F11-D11","v":351471.38625000045},null,{"$f":"(Inputs!$C$8*(Inputs!$C$14+Inputs!$C$16))+(Inputs!$C$8*(Inputs!$C$15+Inputs!$C$17))","v":5762476.3862500004},{"$f":"I11-D11","v":351471.38625000045},null,"The number of doses administered to children, including both MCV1 and MCV2 doses",null,null,{"$f":"IF(F11-D11=0,\"Since baseline MCV1 and MCV2 coverage is greater than 95%, this analysis assumes no increase of coverage or the number of children vaccinated by switching to 5-dose vials\",(_xlfn.CONCAT(\"An additional \",TEXT(ABS(F11-D11),\"###,###,###\"),\" doses will be administered each year (including MCV1 and MCV2), which is an increase of \",TEXT(ABS(((D11-F11)/D11)),\"0%\"))))","v":"An additional 351,471 doses will be administered each year (including MCV1 and MCV2), which is an increase of 6%"}]
[null,"Number of doses wasted",null,{"$f":"D10-D11","v":2377975.8550453447},null,{"$f":"F10-F11","v":1112346.3126881998},{"$f":"F12-D12","v":-1265629.5423571449},null,{"$f":"I10-I11","v":1112346.3126881998},{"$f":"I12-D12","v":-1265629.5423571449},null,"The number of doses wasted out of the total required supply, based on wastage rates",null,null,{"$f":"(_xlfn.CONCAT(\"The number of doses wasted will \",IF(F12<D12,\"decrease \",\"increase \"),\"by approximately \",TEXT(ABS(F12-D12),\"###,###,###\"),\" doses, or by \",TEXT(ABS(((D12-F12)/D12)),\"0%\")))","v":"The number of doses wasted will decrease by approximately 1,265,630 doses, or by 53%"}]
[]
[]
[null,"TOTAL SYSTEMS COSTS (PER VACCINATED CHILD)"]
[]
[null,null,null,"CURRENT 10-DOSE VIAL PRODUCT",null,"OPTION 1\n(5-DOSE VIAL)",null,null,"OPTION 2\n(5-DOSE VIAL)",null,null,"Description",null,null,"Interpretation\n(All values are comparing Option 1 with 10-dose vial product)"]
[null,"Vaccine and presentation",null,{"$f":"Inputs!$C$35","v":"Measles, SII\n 10-dose vial"},null,{"$f":"Inputs!$E$35","v":"Measles, SII\n 5-dose vial"},null,null,{"$f":"Inputs!$G$35","v":"Measles, SII\n 5-dose vial"}]
[null,"Output and difference",null,"Output",null,"Output","Difference (5d minus 10d)",null,"Output","Difference (5d minus 10d)"]
[null,"Vaccine procurement price",null,{"$f":"Inputs!C36","v":0.42299999999999999},null,{"$f":"Inputs!E36","v":0.52200000000000002},{"$f":"F20-D20","v":9.9000000000000032E-2},null,{"$f":"Inputs!G36","v":0.52200000000000002},{"$f":"I20-D20","v":9.9000000000000032E-2},null,"The vaccine price per dose",null,null,{"$f":"_xlfn.CONCAT(\"Without adjusting for wastage, 5-dose vials are \",TEXT(ABS(F20-D20),\"$0.00\"),\"  more expensive than 10-dose vials\")","v":"Without adjusting for wastage, 5-dose vials are $0.10  more expensive than 10-dose vials"}]
[null,"Vaccine procurement cost per vaccinated child",null,{"$f":"Inputs!C$36*Results!D$10/D$11","v":0.60889592629912204},null,{"$f":"Inputs!E$36*Results!F$10/F$11","v":0.62276306370794554},{"$f":"F21-D21","v":1.3867137408823504E-2},null,{"$f":"Inputs!G$36*Results!I$10/I$11","v":0.62276306370794554},{"$f":"I21-D21","v":1.3867137408823504E-2},null,"The vaccine cost per dose administered, adjusted for wastage and coverage",null,null,{"$f":"_xlfn.CONCAT(\"After adjusting for wastage and coverage, the vaccine procurement cost per vaccinated child is \",IF(F21>D21,_xlfn.CONCAT(TEXT(ABS(F21-D21),\"$0.00\"),\" more expensive than 10-dose vials\"),IF(F21<D21,_xlfn.CONCAT(TEXT(ABS(F21-D21),\"$0.00\"),\" cheaper than 10-dose vials\"),\" the same as 10-dose vials\")))","v":"After adjusting for wastage and coverage, the vaccine procurement cost per vaccinated child is $0.01 more expensive than 10-dose vials"}]
[null,"Total costs per vaccinated child",null,{"$f":"Inputs!C$36*Results!D$10/D$11","v":0.60889592629912204},null,{"$f":"(Inputs!E$36*Results!F$10/F$11)+Inputs!$C$28","v":0.73276306370794553},{"$f":"F22-D22","v":0.12386713740882349},null,{"$f":"(Inputs!G$36*Results!I$10/I$11)+Inputs!$C$28","v":0.73276306370794553},0.12386713740882349,null,"The wastage-adjusted vaccine procurement cost per vaccinated child. For 5-dose vials, this also includes the incremental non-vaccine costs per vaccinated child associated with switching from 10- to 5-dose vials.",null,null,{"$f":"_xlfn.CONCAT(IF($F$22>$D$22,\"The 5-dose vials have higher total costs per vaccinated child than 10-dose vials, mostly attributable to incremental non-vaccine costs\",\"The 5-dose vials have lower total costs per vaccinated child than 10-dose vials, even after accounting for the incremental non-vaccine costs associated with switching to 5-dose vials\"))","v":"The 5-dose vials have higher total costs per vaccinated child than 10-dose vials, mostly attributable to incremental non-vaccine costs"}]
[]
[null,"TOTAL SYSTEMS COSTS (FOR COUNTRY & GAVI)"]
[]
[null,null,null,"CURRENT 10-DOSE VIAL PRODUCT",null,"OPTION 1\n(5-DOSE VIAL)",null,null,"OPTION 2\n(5-DOSE VIAL)",null,null,"Description",null,null,"Interpretation\n(All values are comparing Option 1 with 10-dose vial product)"]
[null,"Vaccine and presentation",null,{"$f":"Inputs!$C$35","v":"Measles, SII\n 10-dose vial"},null,{"$f":"Inputs!$E$35","v":"Measles, SII\n 5-dose vial"},null,null,{"$f":"Inputs!$G$35","v":"Measles, SII\n 5-dose vial"}]
[null,"Output and difference",null,"Output",null,"Output","Difference (5d minus 10d)",null,"Output","Difference (5d minus 10d)"]
[null,"Total vaccine procurement costs","For country",{"$f":"Inputs!C$36*Results!D$10*Inputs!$C$10","v":3294738.9016841808},null,{"$f":"Inputs!E$36*Results!F$10*Inputs!$C$10","v":3588657.4488457409},{"$f":"F29-D29","v":293918.54716156004},null,{"$f":"Inputs!G$36*Results!I$10*Inputs!$C$10","v":3588657.4488457409},293918.54716156004,null,"The total vaccine procurement costs to country (vaccine price * total required supply * country co-financing share)",null,null,{"$f":"(_xlfn.CONCAT(\"The total vaccine procurement costs for \",Inputs!C7,\" will be approximately \",IF(Results!F29>Results!D29,_xlfn.CONCAT(TEXT(ABS(Results!F29-Results!D29),\"$###,###,###\"),\" more\"),_xlfn.CONCAT(TEXT(ABS(Results!F29-Results!D29),\"$###,###,###\"),\" less\")),\" expensive for 5-dose vials than for 10-dose vials\"))","v":"The total vaccine procurement costs for Indonesia will be approximately $293,919 more expensive for 5-dose vials than for 10-dose vials"}]
[null,null,"For Gavi",{"$f":"Inputs!C$36*Results!D$10*(1-Inputs!$C$10)","v":0},null,{"$f":"Inputs!E$36*Results!F$10*(1-Inputs!$C$10)","v":0},{"$f":"F30-D30","v":0},null,{"$f":"Inputs!G$36*Results!I$10*(1-Inputs!$C$10)","v":0},0,null,"The total vaccine procurement costs to Gavi (vaccine price * total required supply * (1 - country-cofinancing share))",null,null,{"$f":"IF(F30=0,\"Gavi does not co-finance this vaccine\",(_xlfn.CONCAT(\"The total vaccine procurement costs for Gavi will be approximately \",IF(Results!F30>Results!D30,_xlfn.CONCAT(TEXT(ABS(Results!F30-Results!D30),\"$###,###,###\"),\" more\"),_xlfn.CONCAT(TEXT(ABS(Results!F30-Results!D30),\"$###,###,###\"),\" less\")),\" expensive for 5-dose vials than for 10-dose vials\")))","v":"Gavi does not co-finance this vaccine"}]
[null,null,"Total",{"$f":"SUM(D29:D30)","v":3294738.9016841808},null,{"$f":"SUM(F29:F30)","v":3588657.4488457409},{"$f":"SUM(G29:G30)","v":293918.54716156004},null,{"$f":"SUM(I29:I30)","v":3588657.4488457409},{"$f":"SUM(J29:J30)","v":293918.54716156004},null,"The sum of the vaccine procurement cost for the country and Gavi",null,null,{"$f":"(_xlfn.CONCAT(\"The total vaccine procurement costs for \",Inputs!C7,\" and Gavi will be approximately \",IF(Results!F31>Results!D31,_xlfn.CONCAT(TEXT(ABS(Results!F31-Results!D31),\"$###,###,###\"),\" more\"),_xlfn.CONCAT(TEXT(ABS(Results!F31-Results!D31),\"$###,###,###\"),\" less\")),\" expensive for 5-dose vials than for 10-dose vials\"))","v":"The total vaccine procurement costs for Indonesia and Gavi will be approximately $293,919 more expensive for 5-dose vials than for 10-dose vials"}]
[null,"Total incremental non-vaccine costs","For country",{"$f":"D11*0","v":0},null,{"$f":"(Inputs!$C$28*Results!F11)","v":633872.40248750011},{"$f":"F32-D32","v":633872.40248750011},null,{"$f":"(Inputs!$C$28*Results!I11)","v":633872.40248750011},{"$f":"I32-D32","v":633872.40248750011},null,"Incremental non-vaccine costs per 5-dose vial administered * number of doses administered",null,null,{"$f":"_xlfn.CONCAT(\"An additional \",(TEXT(ABS(G32),\"$###,###,###\")),\" is expected for non-vaccine costs associated with switching to 5-dose vials for things such as cold chain, transport, outreach, human resources, and wastage disposal costs\")","v":"An additional $633,872 is expected for non-vaccine costs associated with switching to 5-dose vials for things such as cold chain, transport, outreach, human resources, and wastage disposal costs"}]
[null,"Total vaccination program costs","For country",{"$f":"SUM(D29,D32)","v":3294738.9016841808},null,{"$f":"SUM(F29,F32)","v":4222529.851333241},{"$f":"F33-D33","v":927790.94964906015},null,{"$f":"SUM(I29,I32)","v":4222529.851333241},{"$f":"I33-D33","v":927790.94964906015},null,"The total vaccine procurement costs to country. For 5-dose vials, this also includes the incremental non-vaccine costs associated with switching from 10- to 5-dose vials.",null,null,{"$f":"(_xlfn.CONCAT(\"The total costs for \",Inputs!C7,\", also taking into account incremental non-vaccine costs for 5-dose vials, will be approximately \",IF(Results!F33>Results!D33,_xlfn.CONCAT(TEXT(ABS(Results!F33-Results!D33),\"$###,###,###\"),\" more\"),_xlfn.CONCAT(TEXT(ABS(Results!F33-Results!D33),\"$###,###,###\"),\" less\")),\" expensive for 5-dose vials than for 10-dose vials\"))","v":"The total costs for Indonesia, also taking into account incremental non-vaccine costs for 5-dose vials, will be approximately $927,791 more expensive for 5-dose vials than for 10-dose vials"}]
[null,null,"Total (including Gavi procurement costs)",{"$f":"SUM(D29,D30,D32)","v":3294738.9016841808},null,{"$f":"SUM(F29,F30,F32)","v":4222529.851333241},{"$f":"F34-D34","v":927790.94964906015},null,{"$f":"SUM(I29,I30,I32)","v":4222529.851333241},{"$f":"I34-D34","v":927790.94964906015},null,"The total vaccine procurement costs to country and Gavi and the incremental programmatic costs for 5-dose vials.",null,null,{"$f":"(_xlfn.CONCAT(\"The total costs for \",Inputs!C7,\" and Gavi, also taking into account incremental non-vaccine costs for 5-dose vials, will be approximately \",TEXT(F34,\"$###,###,###\"),\", which is \",IF(Results!F34>Results!D34,_xlfn.CONCAT(TEXT(ABS(Results!F34-Results!D34),\"$###,###,###\"),\" more\"),_xlfn.CONCAT(TEXT(ABS(Results!F34-Results!D34),\"$###,###,###\"),\" less\")),\" expensive than 10-dose vials\"))","v":"The total costs for Indonesia and Gavi, also taking into account incremental non-vaccine costs for 5-dose vials, will be approximately $4,222,530, which is $927,791 more expensive than 10-dose vials"}]
[]
[]
[null,"COLD CHAIN REQUIREMENTS"]
[]
[null,null,null,"CURRENT 10-DOSE VIAL PRODUCT",null,"OPTION 1\n(5-DOSE VIAL)",null,null,"OPTION 2\n(5-DOSE VIAL)",null,null,"Description",null,null,"Interpretation\n(All values are comparing Option 1 with 10-dose vial product"]
[null,"Vaccine and presentation",null,{"$f":"Inputs!$C$35","v":"Measles, SII\n 10-dose vial"},null,{"$f":"Inputs!$E$35","v":"Measles, SII\n 5-dose vial"},null,null,{"$f":"Inputs!$G$35","v":"Measles, SII\n 5-dose vial"}]
[null,"Output and difference",null,"Output",null,"Output","Difference (5d minus 10d)",null,"Output","Difference (5d minus 10d)"]
[null,"Cold chain volume per dose (cm3)",null,{"$f":"Inputs!C37","v":5.25},null,{"$f":"Inputs!E37","v":8.64},{"$f":"F42-D42","v":3.3900000000000006},null,{"$f":"Inputs!G37","v":8.64},{"$f":"I42-D42","v":3.3900000000000006},null,"Cold chain volume required per dose (in cm3) from the Gavi Detailed Product Profiles (includes vial and ampoule)",null,null,{"$f":"IF(F42>D42,_xlfn.CONCAT(\"5-dose vials take up \",TEXT(ABS(F42-D42),\"##.##\"),\" cm3 more cold chain volume per dose than 10-dose vials\"),_xlfn.CONCAT(\"5-dose vials take up \",TEXT(ABS(F42-D42),\"##.##\"),\" cm3 less cold chain volume per dose than 10-dose vials\"))","v":"5-dose vials take up 3.39 cm3 more cold chain volume per dose than 10-dose vials"}]
[null,"Cold chain volume per vaccinated child (cm3)",null,{"$f":"(D42*D10)/D11","v":7.5572189434288193},null,{"$f":"(F42*F10)/F11","v":10.307802433786685},2.7505834903578661,null,{"$f":"(I42*I10)/I11","v":10.307802433786685},{"$f":"I43-D43","v":2.7505834903578661},null,"Cold chain volume per dose administered, adjusted for wastage",null,null,{"$f":"_xlfn.CONCAT(\"After adjusting for wastage and coverage, \",IF(F43>D43,_xlfn.CONCAT(\"5-dose vials take up \",TEXT(ABS(F43-D43),\"##.##\"),\" cm3 more cold chain volume per dose than 10-dose vials\"),_xlfn.CONCAT(\"5-dose vials take up \",TEXT(ABS(F43-D43),\"##.##\"),\" cm3 less cold chain volume per dose than 10-dose vials\")))","v":"After adjusting for wastage and coverage, 5-dose vials take up 2.75 cm3 more cold chain volume per dose than 10-dose vials"}]
[null,"Total vaccine cold chain volume in country (cm3)",null,{"$f":"D42*D10","v":40892149.488988057},null,{"$f":"F42*F10","v":59398468.118826054},18506318.629837997,null,{"$f":"I42*I10","v":59398468.118826054},{"$f":"I44-D44","v":18506318.629837997},null,"Total vaccine cold chain required in country (cold chain volume per dose * total required supply)",null,null,{"$f":"(_xlfn.CONCAT(\"The total cold chain volume for \",Inputs!C7,\" will be approximately \",IF(Results!F44>Results!D44,_xlfn.CONCAT(TEXT(ABS(Results!F44-Results!D44),\"###,###,###\"),\" cm3 more\"),_xlfn.CONCAT(TEXT(ABS(Results!F44-Results!D44),\"###,###,###\"),\" cm3 less\")),\" for 5-dose vials than for 10-dose vials\"))","v":"The total cold chain volume for Indonesia will be approximately 18,506,319 cm3 more for 5-dose vials than for 10-dose vials"},null,null,null,null,null,null,null,null,null,null,null,null,"d"]
[null,"Net storage per dose (cm3)",null,88.5,null,93.7,5.2000000000000028,null,93.7,5.2000000000000028,null,"The Zambia study looked at the net storage required per fully immunized child, considering cold boxes, vaccine carriers, and refrigerators",null,null,"The Zambia study found that the difference in total net storage requirement per fully immunized child, including the vaccine, was marginal "]
[]
[]
[null,"<<< GO TO IMPACT >>>"]

{"sheet":"Impact","index":3,"n_rows":41,"n_cols":4,"rows_kept":41,"cut":false,"hidden":false,"merged":[[39,3,39,14],[40,3,40,14],[31,1,31,14],[33,1,33,14],[34,1,34,14],[36,1,36,14],[37,1,37,14],[38,3,38,14],[30,1,30,14],[22,1,22,14],[24,1,24,14],[25,1,25,14],[27,1,27,14],[28,1,28,14],[17,1,17,14],[18,1,18,14],[19,1,19,14],[11,1,11,14],[12,1,12,14],[13,1,13,14],[14,1,14,14],[7,1,7,14],[8,1,8,14],[1,1,1,7],[2,1,2,14],[4,1,4,14],[5,1,5,14],[6,1,6,14]]}
[null,"MCV 5-Dose Vial Assessment Support Tool - Results (annual)"]
[null,"For questions or support, contact Linksbridge's MCV 5-dose team: lena.stashko@linksbridge.com; sheldon.halsted@linksbridge.com; and/or maggie.archbold@linksbridge.com"]
[null,{"$f":"_xlfn.CONCAT(\"Impact: \",UPPER(Inputs!$C$7))","v":"Impact: INDONESIA"}]
[]
[null,"VACCINE DELIVERY"]
[null,{"$f":"_xlfn.CONCAT(\"KEY TAKEAWAYS OF OPTION 1: Switching to 5-dose vials results in lower total required supply\",IF(Results!F11=Results!D11,\"\",\", more children vaccinated,\"),\" and fewer doses wasted than with 10-dose vials\")","v":"KEY TAKEAWAYS OF OPTION 1: Switching to 5-dose vials results in lower total required supply, more children vaccinated, and fewer doses wasted than with 10-dose vials"}]
[null,{"$f":"(_xlfn.CONCAT(\"The total required supply will reduce by \",TEXT(ABS(Results!D10-Results!F10),\"###,###,###\"),\" doses annually, or by \",TEXT(ABS(((Results!D10-Results!F10)/Results!D10)),\"0%\")))","v":"The total required supply will reduce by 914,158 doses annually, or by 12%"}]
[null,{"$f":"IF(Results!D11-Results!F11=0,\"Since baseline MCV1 and MCV2 coverage is greater than 95%, this analysis assumes no increase of coverage or the number of children vaccinated by switching to 5-dose vials\",(_xlfn.CONCAT(\"An additional \",TEXT(ABS(Results!D11-Results!F11),\"###,###,###\"),\" doses will be administered each year (including MCV1 and MCV2), which is an increase of \",TEXT(ABS(((Results!D11-Results!F11)/Results!D11)),\"0%\"))))","v":"An additional 351,471 doses will be administered each year (including MCV1 and MCV2), which is an increase of 6%"}]
[null,{"$f":"(_xlfn.CONCAT(\"The number of doses wasted will \",IF(Results!F12<Results!D12,\"decrease \",\"increase \"),\"by approximately \",TEXT(ABS(Results!F12-Results!D12),\"###,###,###\"),\" doses, or by \",TEXT(ABS(((Results!D12-Results!F12)/Results!D12)),\"0%\")))","v":"The number of doses wasted will decrease by approximately 1,265,630 doses, or by 53%"}]
[]
[]
[null,"TOTAL SYSTEMS COSTS"]
[null,{"$f":"_xlfn.CONCAT(\"KEY TAKEAWAYS OF OPTION 1: \",IF(Results!F21>Results!D21,\"After adjusting for wastage and coverage, the vaccine procurement cost is marginally higher for 5-dose vials\",\"After adjusting for wastage and coverage, the vaccine procurement cost is cheaper for 5-dose vials than for 10-dose vials\"),\". In addition to the vaccine procurement cost, \",Inputs!C7,\" should also take into account the incremental non-vaccine costs associated with switching to 5-dose vials. Costs associated with switching may be offset by a Gavi switch grant, if eligible.\")","v":"KEY TAKEAWAYS OF OPTION 1: After adjusting for wastage and coverage, the vaccine procurement cost is marginally higher for 5-dose vials. In addition to the vaccine procurement cost, Indonesia should also take into account the incremental non-vaccine costs associated with switching to 5-dose vials. Costs associated with switching may be offset by a Gavi switch grant, if eligible."}]
[null,{"$f":"(_xlfn.CONCAT(\"The total vaccine procurement costs for \",Inputs!C7,\" will be approximately \",TEXT(Results!F29,\"$###,###,###\"),\", which is \",IF(Results!F29>Results!D29,_xlfn.CONCAT(TEXT(ABS(Results!F29-Results!D29),\"$###,###,###\"),\" more\"),_xlfn.CONCAT(TEXT(ABS(Results!F29-Results!D29),\"$###,###,###\"),\" less\")),\" expensive for 5-dose vials than for 10-dose vials, taking into account potential co-financing\"))","v":"The total vaccine procurement costs for Indonesia will be approximately $3,588,657, which is $293,919 more expensive for 5-dose vials than for 10-dose vials, taking into account potential co-financing"}]
[null,{"$f":"(_xlfn.CONCAT(\"The total costs for \",Inputs!C7,\", also taking into account incremental non-vaccine costs for 5-dose vials, will be approximately \",TEXT(Results!F33,\"$###,###,###\"),\", which is \",IF(Results!F33>Results!D33,_xlfn.CONCAT(TEXT(ABS(Results!F33-Results!D33),\"$###,###,###\"),\" more\"),_xlfn.CONCAT(TEXT(ABS(Results!F33-Results!D33),\"$###,###,###\"),\" less\")),\" expensive for 5-dose vials than for 10-dose vials\"))","v":"The total costs for Indonesia, also taking into account incremental non-vaccine costs for 5-dose vials, will be approximately $4,222,530, which is $927,791 more expensive for 5-dose vials than for 10-dose vials"}]
[]
[]
[null,"COLD CHAIN REQUIREMENTS"]
[null,"KEY TAKEAWAYS OF OPTION 1: While 5-dose vials take up more cold chain space per dose, this is offset by the lower total required supply, and all health facilities in the Zambia study had sufficient cold chain space. The Zambia study found that the difference in total net storage requirement per fully immunized child, including the vaccine, was marginal."]
[null,{"$f":"(_xlfn.CONCAT(\"The total cold chain volume for \",Inputs!C7,\" will be approximately \",IF(Results!F44>Results!D44,_xlfn.CONCAT(TEXT(ABS(Results!F44-Results!D44),\"###,###,###\"),\" cm3 more\"),_xlfn.CONCAT(TEXT(ABS(Results!F44-Results!D44),\"###,###,###\"),\" cm3 less\")),\" for 5-dose vials than for 10-dose vials\"))","v":"The total cold chain volume for Indonesia will be approximately 18,506,319 cm3 more for 5-dose vials than for 10-dose vials"}]
[]
[]
[null,"ADDITIONAL CONSIDERATIONS:"]
[]
[null,"EQUITY"]
[null,"• MCV 5-dose is a delivery-based innovation that can help reach un-/under-immunized children, especially in rural and remote areas where session sizes tend to be small\n• Minimizing missed opportunities for vaccination will help drive progress towards achieving equity goals in immunization "]
[]
[null,"HEALTHCARE WORKER BEHAVIOR"]
[null,"• Despite open vial policies that promote ‘one vial one child,’ healthcare worker reluctance to open vials remains a challenge in routine immunization \n• MCV 5-dose will reduce healthcare worker hesitancy to open a vial due to fear of wastage and/or stockouts\n• Use of 5-dose will improve timely coverage and reduce missed opportunities for vaccination, while also reducing wastage"]
[]
[null,"SAFETY"]
[null,"• Increasing the doses per container increases the opportunity for user error, which may raise the likelihood of non-sterile injections and injections with expired vaccine. MCV 5-dose could help reduce this risk."]
[]
[null,"MARKET HEALTH"]
[null,"• MCV 5-dose is an intervention that would improve routine immunization coverage, thus hopefully reducing the country's reliance on campaigns and minimizing the unpredictability of demand year-over-year"]
[]
[null,"ONE-TIME SWITCH COSTS AND GAVI GRANT"]
[null,"• There may be additional one-time switch costs associated with switching to 5-dose vials\n• Gavi countries may be eligible for a Gavi switch grant to offset the costs associated with switching to 5-dose vials"]
[null,"One-time switch costs",0,"Switching vaccine presentations might have additional financial implications in the first year. Here you can enter an optional lump sum or budget for switching to 5-dose vials in the first year."]
[null,"Gavi switch grant",{"$f":"IF(Inputs!$C$8*0.25>30000,Inputs!$C$8*0.25,30000)","v":1108812.5},"Gavi switch grants (SGs) are one-time subsidies provided by Gavi to offset a share of the costs related to switching to a new vaccine. Calculated as $0.25 per infant in the birth cohort or a lump sum of $30,000, whichever is higher."]
[null,"Additional costs / savings",{"$f":"C40-C39","v":1108812.5},"Calculated as Gavi switch grant minus one-time switch costs"]

{"sheet":"Coverage Data","index":4,"n_rows":102,"n_cols":3,"rows_kept":102,"cut":false,"hidden":true,"merged":[]}
["Coverage Data"]
["Baseline coverage","MCV1 coverage increase","MCV2 coverage increase"]
[0.01,4.9000000000000002E-2,3.5000000000000003E-2]
[0.02,4.9000000000000002E-2,3.5000000000000003E-2]
[0.03,4.9000000000000002E-2,3.5000000000000003E-2]
[0.04,4.9000000000000002E-2,3.5000000000000003E-2]
[0.05,4.9000000000000002E-2,3.5000000000000003E-2]
[0.06,4.9000000000000002E-2,3.5000000000000003E-2]
[7.0000000000000007E-2,4.9000000000000002E-2,3.5000000000000003E-2]
[0.08,4.9000000000000002E-2,3.5000000000000003E-2]
[0.09,4.9000000000000002E-2,3.5000000000000003E-2]
[0.1,4.9000000000000002E-2,3.5000000000000003E-2]
[0.11,4.9000000000000002E-2,3.5000000000000003E-2]
[0.12,4.9000000000000002E-2,3.5000000000000003E-2]
[0.13,4.9000000000000002E-2,3.5000000000000003E-2]
[0.14000000000000001,4.9000000000000002E-2,3.5000000000000003E-2]
[0.15,4.9000000000000002E-2,3.5000000000000003E-2]
[0.16,4.9000000000000002E-2,3.5000000000000003E-2]
[0.17,4.9000000000000002E-2,3.5000000000000003E-2]
[0.18,4.9000000000000002E-2,3.5000000000000003E-2]
[0.19,4.9000000000000002E-2,3.5000000000000003E-2]
[0.2,4.9000000000000002E-2,3.5000000000000003E-2]
[0.21,4.9000000000000002E-2,3.5000000000000003E-2]
[0.22,4.9000000000000002E-2,3.5000000000000003E-2]
[0.23,4.9000000000000002E-2,3.5000000000000003E-2]
[0.24,4.9000000000000002E-2,3.5000000000000003E-2]
[0.25,4.9000000000000002E-2,3.5000000000000003E-2]
[0.26,4.9000000000000002E-2,3.5000000000000003E-2]
[0.27,4.9000000000000002E-2,3.5000000000000003E-2]
[0.28000000000000003,4.9000000000000002E-2,3.5000000000000003E-2]
[0.28999999999999998,4.9000000000000002E-2,3.5000000000000003E-2]
[0.3,4.9000000000000002E-2,3.5000000000000003E-2]
[0.31,4.9000000000000002E-2,3.5000000000000003E-2]
[0.32,4.9000000000000002E-2,3.5000000000000003E-2]
[0.33,4.9000000000000002E-2,3.5000000000000003E-2]
[0.34,4.9000000000000002E-2,3.5000000000000003E-2]
[0.35,4.9000000000000002E-2,3.5000000000000003E-2]
[0.36,4.9000000000000002E-2,3.5000000000000003E-2]
[0.37,4.9000000000000002E-2,3.5000000000000003E-2]
[0.38,4.9000000000000002E-2,3.5000000000000003E-2]
[0.39,4.9000000000000002E-2,3.5000000000000003E-2]
[0.4,4.9000000000000002E-2,3.5000000000000003E-2]
[0.41,4.9000000000000002E-2,3.5000000000000003E-2]
[0.42,4.9000000000000002E-2,3.5000000000000003E-2]
[0.43,4.9000000000000002E-2,3.5000000000000003E-2]
[0.44,4.9000000000000002E-2,3.4283600000000025E-2]
[0.45,4.9000000000000002E-2,3.3610500000000043E-2]
[0.46,4.9000000000000002E-2,3.2937400000000006E-2]
[0.47,4.9000000000000002E-2,3.2264300000000024E-2]
[0.48,4.9000000000000002E-2,3.1591200000000041E-2]
[0.49,4.9000000000000002E-2,3.0918099999999948E-2]
[0.5,4.9000000000000002E-2,3.0244999999999966E-2]
[0.51,4.9000000000000002E-2,2.9571899999999984E-2]
[0.52,4.9000000000000002E-2,2.8898800000000002E-2]
[0.53,4.9000000000000002E-2,2.822570000000002E-2]
[0.54,4.9000000000000002E-2,2.7552599999999927E-2]
[0.55000000000000004,4.9000000000000002E-2,2.6879499999999945E-2]
[0.56000000000000005,4.9000000000000002E-2,2.6206399999999963E-2]
[0.56999999999999995,4.9000000000000002E-2,2.5533299999999981E-2]
[0.57999999999999996,4.9000000000000002E-2,2.4860199999999999E-2]
[0.59,4.9000000000000002E-2,2.4187100000000017E-2]
[0.6,4.9000000000000002E-2,2.3513999999999924E-2]
[0.61,4.9000000000000002E-2,2.2840899999999942E-2]
[0.62,4.9000000000000002E-2,2.216779999999996E-2]
[0.63,4.9000000000000002E-2,2.1494699999999978E-2]
[0.64,4.9000000000000002E-2,2.0821599999999996E-2]
[0.65,4.9000000000000002E-2,2.0148500000000014E-2]
[0.66,4.9000000000000002E-2,1.9475399999999921E-2]
[0.67,4.9000000000000002E-2,1.8802299999999939E-2]
[0.68,4.9000000000000002E-2,1.8129199999999956E-2]
[0.69,4.9000000000000002E-2,1.7456099999999974E-2]
[0.7,4.9000000000000002E-2,1.6782999999999992E-2]
[0.71,4.9000000000000002E-2,1.610990000000001E-2]
[0.72,4.9000000000000002E-2,1.5436799999999917E-2]
[0.73,4.9000000000000002E-2,1.4763699999999935E-2]
[0.74,4.9000000000000002E-2,1.4090599999999953E-2]
[0.75,4.9000000000000002E-2,1.3417499999999971E-2]
[0.76,4.9000000000000002E-2,1.2744399999999989E-2]
[0.77,4.9000000000000002E-2,1.2071300000000007E-2]
[0.78,4.9000000000000002E-2,1.1398200000000025E-2]
[0.79,4.9000000000000002E-2,1.0725099999999932E-2]
[0.8,4.9000000000000002E-2,1.005199999999995E-2]
[0.81,4.9000000000000002E-2,9.3788999999999678E-3]
[0.82,4.9000000000000002E-2,8.7057999999999858E-3]
[0.83,4.5599999999999974E-2,8.0327000000000037E-3]
[0.84,4.1799999999999948E-2,7.3596000000000217E-3]
[0.85,3.8000000000000034E-2,6.6864999999999286E-3]
[0.86,3.4200000000000008E-2,6.0133999999999466E-3]
[0.87,3.0399999999999983E-2,5.3402999999999645E-3]
[0.88,2.6599999999999957E-2,4.6671999999999825E-3]
[0.89,2.2799999999999931E-2,3.9941000000000004E-3]
[0.9,1.9000000000000017E-2,3.3210000000000184E-3]
[0.91,1.5199999999999991E-2,2.6478999999999253E-3]
[0.92,1.1399999999999966E-2,1.9747999999999433E-3]
[0.93,7.5999999999999401E-3,1.3016999999999612E-3]
[0.94,3.8000000000000256E-3,6.2859999999997918E-4]
[0.95,0,-4.4500000000002871E-5]
[0.96,0,0]
[0.97,0,0]
[0.98,0,0]
[0.99,0,0]
[1,0,0]

{"sheet":"Country Data","index":5,"n_rows":196,"n_cols":5,"rows_kept":196,"cut":false,"hidden":true,"merged":[]}
["Country Data (coverage & birth cohort size)"]
["ISO_code","Country","MCV1 Coverage (2021)","MCV2 Coverage (2021)","Birth Cohort (2022)"]
["AFG","Afghanistan",0.63,0.44,1368682]
["ALB","Albania",0.87,0.92,28218.5]
["DZA","Algeria",0.8,0.77,946304.5]
["AND","Andorra",0.99,0.97,335.5]
["AGO","Angola",0.36,0.32,1275483.5]
["ATG","Antigua",0.85,0.76,1123.5]
["ARG","Argentina",0.81,0.79,627545]
["ARM","Armenia",0.94,0.94,34060]
["AUS","Australia",0.93,0.94,298603]
["AUT","Austria",0.95,0.88,84112.5]
["AZE","Azerbaijan",0.93,0.9,127570.5]
["BHS","Bahamas",0.82,0.82,4631]
["BHR","Bahrain",0.99,0.99,17818]
["BGD","Bangladesh",0.97,0.93,2957644]
["BRB","Barbados",0.77,0.7,3018]
["BLR","Belarus",0.98,0.98,88439]
["BEL","Belgium",0.96,0.85,116052]
["BLZ","Belize",0.79,0.77,7064.5]
["BEN","Benin",0.68,0,451776]
["BTN","Bhutan",0.97,0.91,9542.5]
["BOL","Bolivia",0.75,0.56000000000000005,257302.5]
["BIH","Bosnia",0.68,0.76,28459]
["BWA","Botswana",0.97,0.7,59558.5]
["BRA","Brazil",0.73,0.46,2743222.5]
["BRN","Brunei",0.99,0.99,6148.5]
["BGR","Bulgaria",0.89,0.86,58299]
["BFA","Burkina Faso",0.88,0.71,749609.5]
["BDI","Burundi",0.9,0.85,422264.5]
["CPV","Cabo Verde",0.95,0.86,9869]
["KHM","Cambodia",0.84,0.71,316916]
["CMR","Cameroon",0.62,0.35,909148.5]
["CAN","Canada",0.9,0.83,373863.5]
["CAF","CAR",0.41,0,217886.5]
["TCD","Chad",0.55000000000000004,0,699185]
["CHL","Chile",0.92,0.57999999999999996,229215.5]
["CHN","China",0.99,0.99,11501936]
["COL","Colombia",0.86,0.86,728292.5]
["COM","Comoros",0.82,0.19,23262.5]
["COG","Congo",0.68,0.31,173538]
["COK","Cook Islands",0.99,0.98,277]
["CRI","Costa Rica",0.89,0.69,61381.5]
["CIV","Cote d'Ivoire",0.68,0.01,884803]
["HRV","Croatia",0.89,0.9,35075.5]
["CUB","Cuba",0.99,0.99,102559.5]
["CYP","Cyprus",0.86,0.88,12964]
["CZE","Czech Rep.",0.97,0.9,105331.5]
["DNK","Denmark",0.95,0.94,62495]
["DJI","Djibouti",0.5,0.48,23731]
["DMA","Dominica",0.92,0.88,951]
["DOM","Dominican Rep.",0.88,0.6,200801.5]
["COD","DRC",0.55000000000000004,0,3813316]
["ECU","Ecuador",0.65,0.57999999999999996,296920]
["EGY","Egypt",0.96,0.96,2435522]
["SLV","El Salvador",0.86,0.71,100357]
["GNQ","Equatorial Guinea",0.53,0.17,47635]
["ERI","Eritrea",0.93,0.85,100223.5]
["EST","Estonia",0.89,0.84,13801]
["SWZ","Eswatini",0.8,0.69,28062.5]
["ETH","Ethiopia",0.54,0.46,3754002.5]
["FJI","Fiji",0.96,0.94,17646]
["FIN","Finland",0.93,0.93,46790.5]
["FRA","France",0.92,0.86,657766.5]
["GAB","Gabon",0.64,0,61906]
["GMB","Gambia",0.79,0.67,84971]
["GEO","Georgia",0.9,0.81,49238]
["DEU","Germany",0.97,0.93,764994]
["GHA","Ghana",0.94,0.83,878147.5]
["GRC","Greece",0.97,0.83,80566]
["GRD","Grenada",0.83,0.79,1977.5]
["GTM","Guatemala",0.81,0.72,368640.5]
["GIN","Guinea",0.47,0,440646.5]
["GNB","Guinea-Bissau",0.63,0,61311]
["GUY","Guyana",0.94,0.83,15972]
["HTI","Haiti",0.65,0.41,259443.49999999997]
["HND","Honduras",0.81,0.75,213746]
["HUN","Hungary",0.99,0.99,92629.5]
["ISL","Iceland",0.92,0.1,4552.5]
["IND","India",0.89,0.82,22600595]
["IDN","Indonesia",0.72,0.5,4435250]
["IRN","Iran",0.99,0.98,1210915]
["IRQ","Iraq",0.75,0.84,1164101.5]
["IRL","Ireland",0.9,0,59234]
["ISR","Israel",0.99,0.93,174648]
["ITA","Italy",0.92,0.86,409937]
["JAM","Jamaica",0.88,0.85,32860.5]
["JPN","Japan",0.98,0.95,823218]
["JOR","Jordan",0.76,0.9,241394]
["KAZ","Kazakhstan",0.97,0.96,417132.5]
["KEN","Kenya",0.89,0.56999999999999995,1414928]
["KIR","Kiribati",0.8,0.57999999999999996,3390.5]
["KWT","Kuwait",0.94,0.94,46760]
["KGZ","Kyrgyzstan",0.93,0.97,156947.5]
["LAO","Laos",0.73,0.5,158809]
["LVA","Latvia",0.97,0.85,16545.5]
["LBN","Lebanon",0.67,0.59,83772.5]
["LSO","Lesotho",0.9,0.82,56628]
["LBR","Liberia",0.57999999999999996,0.35,154796.5]
["LBY","Libya",0.73,0.72,119904.5]
["LTU","Lithuania",0.88,0.88,26746]
["LUX","Luxembourg",0.99,0.9,6582.5]
["MKD","Macedonia",0.7,0.8,20111]
["MDG","Madagascar",0.39,0.24,862836]
["MWI","Malawi",0.9,0.74,633160]
["MYS","Malaysia",0.96,0.84,508935]
["MDV","Maldives",0.99,0.96,7392.5]
["MLI","Mali",0.7,0.33,862041]
["MLT","Malta",0.9,0.93,4668.5]
["MHL","Marshall Islands",0.85,0.57999999999999996,830]
["MRT","Mauritania",0.63,0,146269]
["MUS","Mauritius",0.77,0.64,13280]
["MEX","Mexico",0.99,0.97,1902030.5]
["FSM","Micronesia",0.64,0.38,2297.5]
["MDA","Moldova",0.83,0.92,37941.5]
["MCO","Monaco",0.88,0.8,322]
["MNG","Mongolia",0.95,0.94,71912]
["MNE","Montenegro",0.18,0.79,7018.5]
["MAR","Morocco",0.99,0.99,644114]
["MOZ","Mozambique",0.84,0.7,1116415]
["MMR","Myanmar",0.44,0.42,896497]
["NAM","Namibia",0.9,0.63,67751.5]
["NRU","Nauru",0.98,0.97,341]
["NPL","Nepal",0.9,0.87,596958]
["NLD","Netherlands",0.93,0.9,176640]
["NZL","New Zealand",0.91,0.82,63744.5]
["NIC","Nicaragua",0.83,0.83,139140.5]
["NER","Niger",0.8,0.66,1087181.5]
["NGA","Nigeria",0.59,0.36,7435960]
["NIU","Niue",0.99,0.99,27]
["PRK","North Korea",0.42,0.41,340427]
["NOR","Norway",0.97,0.95,53543.5]
["OMN","Oman",0.99,0.99,77049.5]
["PAK","Pakistan",0.81,0.79,6093067.5]
["PLW","Palau",0.93,0.84,271.5]
["PAN","Panama",0.8,0.97,76109]
["PNG","Papua New Guinea",0.38,0.2,246277.5]
["PRY","Paraguay",0.68,0.67,136592]
["PER","Peru",0.78,0.6,589314]
["PHL","Philippines",0.56999999999999995,0.55000000000000004,2430020]
["POL","Poland",0.8,0.95,367056]
["PRT","Portugal",0.98,0.95,82668.5]
["QAT","Qatar",0.99,0.99,27562]
["ROU","Romania",0.86,0.75,196252]
["RUS","Russia",0.97,0.96,1418044.5]
["RWA","Rwanda",0.87,0.85,390887.5]
["KNA","Saint Kitts",0.96,0.94,581]
["LCA","Saint Lucia",0.77,0.66,2056]
["VCT","Saint Vincent",0.99,0.99,1343]
["WSM","Samoa",0.62,0.5,5882.5]
["SMR","San Marino",0.89,0.81,204]
["STP","Sao Tome",0.77,0.69,6190]
["SAU","Saudi Arabia",0.98,0.97,637710]
["SEN","Senegal",0.87,0.75,534566.5]
["SRB","Serbia",0.78,0.84,67829]
["SYC","Seychelles",0.94,0.86,1639.5]
["SLE","Sierra Leone",0.87,0.67,249995.5]
["SGP","Singapore",0.95,0.84,41960]
["SVK","Slovakia",0.95,0.96,54840]
["SVN","Slovenia",0.95,0.91,19288]
["SLB","Solomon Islands",0.67,0.4,20688.5]
["SOM","Somalia",0.46,0.04,696080]
["ZAF","South Africa",0.87,0.82,1161080]
["KOR","South Korea",0.98,0.96,291366.5]
["SSD","South Sudan",0.49,0,295787]
["ESP","Spain",0.95,0.91,351137]
["LKA","Sri Lanka",0.97,0.97,304804]
["SDN","Sudan",0.81,0.63,1477254.5]
["SUR","Suriname",0.57999999999999996,0.43,10959.5]
["SWE","Sweden",0.97,0.91,114049.5]
["CHE","Switzerland",0.95,0.94,85819.5]
["SYR","Syria",0.59,0.53,413623.5]
["TJK","Tajikistan",0.97,0.96,255563]
["TZA","Tanzania",0.76,0.62,2216127]
["THA","Thailand",0.96,0.87,646440.5]
["TLS","Timor-Leste",0.79,0.78,31933.5]
["TGO","Togo",0.7,0.5,263971]
["TON","Tonga",0.99,0.99,2425]
["TTO","Trinidad",0.93,0.88,17760]
["TUN","Tunisia",0.95,0.98,197361]
["TUR","Turkey",0.96,0.93,1245242.5]
["TKM","Turkmenistan",0.97,0.98,134015.5]
["TUV","Tuvalu",0.93,0.84,258.5]
["ARE","UAE",0.99,0.96,97099.5]
["UGA","Uganda",0.9,0,1626930]
["GBR","UK",0.91,0.87,679052]
["UKR","Ukraine",0.88,0.86,335939]
["URY","Uruguay",0.96,0.84,35505.5]
["USA","USA",0.91,0.95,3689268]
["UZB","Uzbekistan",0.99,0.99,808376.5]
["VUT","Vanuatu",0.5,0,9195]
["VEN","Venezuela",0.68,0.37,444172]
["VNM","Viet Nam",0.89,0.85,1453562.5]
["YEM","Yemen",0.71,0.52,969879]
["ZMB","Zambia",0.9,0.81,644396]
["ZWE","Zimbabwe",0.85,0.74,472443.5]

{"sheet":"Wastage Data","index":6,"n_rows":5,"n_cols":4,"rows_kept":5,"cut":false,"hidden":true,"merged":[]}
["Wastage Data"]
["Wastage","10-dose","5-dose","Comments"]
["WHO/UNICEF Fact Sheet",0.4,0.3,"Wastage assumptions from the WHO/UNICEF M and MR Vaccine Five-dose vial Presentations Facts Sheet"]
["Zambia Study",0.30530000000000002,0.1618,"Wastage results from the Zambia study"]
["Manually enter wastage assumptions","Manually enter","Manually enter","Enter your own wastage assumptions for the vial size shown"]

{"sheet":"Program Costs","index":7,"n_rows":4,"n_cols":3,"rows_kept":4,"cut":false,"hidden":true,"merged":[]}
["Program Costs"]
["Wastage","Incremental Non-Vaccine Cost","Comments"]
["Zambia Study",0.11,"The Zambia study found that the incremental economic and financial cost per 5-dose vial administered was $0.11 (excluding the cost of the vaccine). Additional costs take into account cold chain, transport, outreach, human resources, and wastage disposal costs. Data came from the DPCP Zambia report."]
["Manually enter program costs","Manually enter","Enter your own programmatic cost assumptions associated with switching to 5-dose vials. This is the incremental, non-vaccine costs per dose administered. Costs take into account things such as cold chain, transport, outreach, human resources, and wastage disposal costs. "]

{"sheet":"Product Data","index":8,"n_rows":11,"n_cols":3,"rows_kept":11,"cut":false,"hidden":true,"merged":[]}
["Product Data"]
["Vaccine","Price per dose (UNICEF, 2023)","Cold chain volume per dose (in cm3)"]
["Measles, SII\n 10-dose vial",0.42299999999999999,{"$f":"2.11+3.14","v":5.25}]
["Measles, Bio Farma\n 10-dose vial",0.27,{"$f":"3.3+2.53","v":5.83}]
["MR, SII\n 10-dose vial",0.873,{"$f":"2.1+3.14","v":5.24}]
["MR, Bio E\n 10-dose vial",0.79200000000000004,{"$f":"1.78+2.12","v":3.9000000000000004}]
["MMR, SII\n 10-dose vial",1.7090000000000001,{"$f":"SUM(2.109+3.1424)","v":5.2514000000000003}]
["Measles, SII\n 5-dose vial",0.52200000000000002,{"$f":"3.16+5.48","v":8.64}]
["MR, SII\n 5-dose vial",1.0900000000000001,{"$f":"3.16+5.49","v":8.65}]
["MR, BioE\n 5-dose vial",0.91800000000000004,{"$f":"2.67+3.25","v":5.92}]
["MMR, SII\n 5-dose vial",1.776,{"$f":"4.218+5.481","v":9.6989999999999998}]

{"sheet":"Gavi co-financing","index":9,"n_rows":6,"n_cols":1,"rows_kept":6,"cut":false,"hidden":true,"merged":[]}
["Gavi co-financing status"]
["Initial self-financing"]
["Preparatory transition"]
["Accelerated transition"]
["Gavi graduated"]
["Non-Gavi"]