Vaccine wastage in Ghana, Mozambique, and Pakistan: An assessment of wastage rates for four vaccines and the context, causes, drivers, and knowledge, attitudes and practices for vaccine wastage.

Autor: Mvundura M; PATH, USA. Electronic address: mmvundura@path.org., Ng J; IQVIA, Singapore., Reynolds K; VillageReach, USA. Electronic address: katie.reynolds@villagereach.org., Theng Ng Y; PATH, USA., Bawa J; PATH, Ghana. Electronic address: jbawa@path.org., Bambo M; VillageReach, Mozambique. Electronic address: miguel.bambo@villagereach.org., Bonsu G; PATH, Ghana. Electronic address: gbonsu@path.org., Payne J; VillageReach, USA. Electronic address: jenny.payne@villagereach.org., Chua J; IQVIA Consultant, Singapore., Guerette J; VillageReach, USA. Electronic address: julia.guerette@villagereach.org., Odei Antwi-Agyei K; PATH, Ghana. Electronic address: koantwiagyei@path.org., Ribe S; EPI, Mozambique., Chinavane D; VillageReach Consultant, Mozambique., Arhin-Wiredu K; PATH, Ghana. Electronic address: kwiredu@path.org., Shah A; EPI, Pakistan. Electronic address: akram.shah@ymail.com., Sitoe J; VillageReach Consultant, Mozambique., Yunus S; EPI, Pakistan., Powelson J; VillageReach, USA. Electronic address: jocelyn.powelson@villagereach.org., Amponsa-Achiano K; EPI, Ghana., Eshioramhe Kojak K; UNICEF, Pakistan. Electronic address: ekelobo@unicef.org., Fredick Dadzie J; EPI, Ghana. Electronic address: jfdadzie@yahoo.co.uk., Asghar N; UNICEF, Pakistan. Electronic address: nasghar@unicef.org., Caetano Correa G; Gavi, Switzerland. Electronic address: gcorrea@gavi.org., Robertson J; PATH, USA. Electronic address: jrobertson@path.org.
Jazyk: angličtina
Zdroj: Vaccine [Vaccine] 2023 Jun 23; Vol. 41 (28), pp. 4158-4169. Date of Electronic Publication: 2023 Jun 01.
DOI: 10.1016/j.vaccine.2023.05.033
Abstrakt: Vaccine procurement costs comprise a significant share of immunization program costs in low- and middle-income countries, yet not all procured vaccines are administered. Vaccine wastage occurs due to vial breakage, excessive heat or freezing, expiration, or when not all doses in a multidose vial are used. Better estimates of vaccine wastage rates and their causes could support improved management of vaccine stocks and reduce procurement costs. This study examined aspects of wastage for four vaccines at service delivery points in Ghana (n = 48), Mozambique (n = 36), and Pakistan (n = 46). We used prospective data from daily and monthly vaccine usage data entry forms, along with cross-sectional surveys, and in-depth interviews. The analysis found that estimated monthly proportional open-vial wastage rates for vaccines in single-dose vials (SDV) or in multi-dose vials (MDV) that can be kept refrigerated up to four weeks after opening ranged from 0.08 % to 3 %. For MDV where remaining doses are discarded within six hours after opening, the mean wastage rates ranged from 5 % to 33 %, with rates being highest for measles containing vaccine. Despite national-level guidance to open a vaccine vial even when only one child is present, vaccines in MDV that are discarded within six hours of opening are sometimes offered less frequently than vaccines in SDV or in MDV where remaining doses can be used for up to 4 weeks. This practice can lead to missed opportunities for vaccination. While closed-vial wastage at service delivery points (SDPs) was relatively rare, individual instances can result in large losses, suggesting that monitoring closed-vial wastage should not be neglected. Health workers reported insufficient knowledge of vaccine wastage tracking and reporting methods. Improving reporting forms would facilitate more accurate reporting of all causes of wastage, as would additional training and supportive supervision. Globally, decreasing doses per vial could reduce open-vial wastage.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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