Doses per vaccine vial container: An understated and underestimated driver of performance that needs more evidence
| Autor: | Kirstin Krudwig, Robert Steinglass, Alexis Heaton, Tina Lorenson, Andrew Cunningham, Craig Burgess |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Vaccination Coverage
030231 tropical medicine 03 medical and health sciences 0302 clinical medicine Humans Medicine 030212 general & internal medicine Operational costs Drug Packaging Vaccines General Veterinary General Immunology and Microbiology business.industry Vaccination Public Health Environmental and Occupational Health Immunization (finance) Product (business) Infectious Diseases Risk analysis (engineering) Low and middle income countries Vaccination coverage Container (abstract data type) Costs and Cost Analysis Molecular Medicine business Healthcare system |
| Zdroj: | Vaccine. 35:2272-2278 |
| ISSN: | 0264-410X |
| DOI: | 10.1016/j.vaccine.2016.11.066 |
| Popis: | The widespread use of multidose vaccine containers in low and middle income countries’ immunization programs is assumed to have multiple benefits and efficiencies for health systems, yet the broader impacts on immunization coverage, costs, and safety are not well understood. To document what is known on this topic, how it has been studied, and confirm the gaps in evidence that allow us to assess the complex system interactions, the authors undertook a review of published literature that explored the relationship between doses per container and immunization systems. The relationships examined in this study are organized within a systems framework consisting of operational costs, timely coverage, safety, product costs/wastage, and policy/correct use, with the idea that a change in dose per container affects all of them, and the optimal solution will depend on what is prioritized and used to measure performance. Studies on this topic are limited and largely rely on modeling to assess the relationship between doses per container and other aspects of immunization systems. Very few studies attempt to look at how a change in doses per container affects vaccination coverage rates and other systems components simultaneously. This article summarizes the published knowledge on this topic to date and suggests areas of current and future research to ultimately improve decision making around vaccine doses per container and increase understanding of how this decision relates to other program goals. |
| Databáze: | OpenAIRE |
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