Vaccine stockouts around the world: Are essential vaccines always available when needed?
Vaccine stockouts around the world: Are essential vaccines always available when needed?
复制标题
DOI：
10.1016/j.vaccine.2016.12.071
复制
发表时间：
2017-04-19
期刊：
影响因子：
5.5
通讯作者：
Senouci, Kamel
中科院分区：
文献类型：
--
作者：
Lydon, Patrick;Schreiber, Benjamin;Senouci, Kamel
简介：随着各国迎接实施“疫苗十年”优先事项及其在全球疫苗行动计划 (GVAP) 中规定的承诺的挑战，许多国家继续面临确保为其国家免疫规划持续供应基本疫苗的重要挑战。这项研究提供了有关各国疫苗缺货发生率、其根本原因及其对服务提供的潜在影响的证据。方法：对从世界卫生组织-联合国儿童基金会联合报告表（JRF）和联合国儿童基金会疫苗预测工具收集的疫苗缺货指标进行了分析，涵盖了全球疫苗行动计划上半年（2011年至2015年），并以2010年为基准年。虽然 JRF 收集有关国家和地方各级疫苗缺货的年度信息，但联合国儿童基金会疫苗预测工具的优势在于，要求联合国儿童基金会采购国报告缺货的原因。 结果：平均每年，每三个世卫组织会员国中就有一个至少经历过一次至少一种疫苗缺货至少一个月的情况。这种情况在撒哈拉以南非洲最为明显，该地区 38% 的国家报告出现国家级缺货情况。受影响最严重的疫苗是含有 DTP 的疫苗（通常与 HepB 和 Hib 联合使用）和 BCG。它们分别占所报告缺货事件的 43% 和 31%。虽然所有收入群体的国家都出现国家级疫苗缺货的情况，但中等收入国家受影响最严重。在 80% 的情况下，国家级缺货是由于国家内部原因造成的。更具体地说，39%的缺货是由于政府资金延误造成的，23%是由于采购流程延误造成的，另外18%是由于国家一级的预测和库存管理不善造成的。当发生国家级疫苗缺货时，有 89% 的可能性会在地区级发生次国家级缺货。更令人担忧的是，如果出现地区级缺货，这将导致96%的情况下疫苗接种服务中断。 讨论：确保基本疫苗的持续供应仍然面临重要挑战。国际社会与各国迫切需要设计有效的干预措施，以减少缺货频率并减轻缺货影响。 (C) 2017 年由爱思唯尔有限公司出版。
Introduction: As countries rise to the challenge of implementing the priorities of this "Decade of Vaccine" and their commitments delineated in the Global Vaccine Action Plan (GVAP), many continue to face important challenges of securing a continuous supply of essential vaccine for their national immunization programme. This study provides evidence on the incidence of vaccine stockouts in countries, their root causes and their potential impact on service delivery.Methods: Vaccine stockout indicators collected from the WHO-UNICEF Joint Reporting Form (JRF) and UNICEF's Vaccine Forecasting Tool were analysed for the years covering the first half of the GVAP (2011 to 2015) and using 2010 as the baseline year. While the JRF collects annual information on national and subnational stockouts by vaccine, the UNICEF Vaccine Forecasting Tool has the advantage of requesting UNICEF procuring countries to report on the reasons underpinning any stockouts.Results: Every year on average, one in every three WHO Member States experiences at least one stockout of at least one vaccine for at least one month. The incidence is most pronounced in Sub-Saharan Africa where 38% of countries in this area of the world report national-level stockouts. The vaccines most affected are DTP containing vaccines (often combined with HepB and Hib) and BCG. They account for respectively 43% and 31% of stockout events reported. While national level vaccine stockouts occur in countries of all income groups, middle income countries are the most affected. In 80% of cases, national level stockouts were due to reasons internal to countries. More specifically, 39% of stockouts were attributable to government funding delays, 23% were caused by delays in the procurement processes, and poor forecasting and stock management at country level accounted for an additional 18%. When a national level stockout of vaccines occurs, there is an 89% chance that a subnational stockout will occur at district level. More concerning is that if a district level stockout occurs, this will lead to an interruption of vaccination services in 96% of cases.Discussion: There continues to be important challenges of ensuring a continuous availability of essential vaccines. The global community, together with countries, urgently need to design effective interventions aimed at reducing the frequency and mitigating the impact of stockouts. (C) 2017 Published by Elsevier Ltd.