The real-life number of neonatal doses of Bacille Calmette-Guerin vaccine in a 20-dose vial
The real-life number of neonatal doses of Bacille Calmette-Guerin vaccine in a 20-dose vial
复制标题
DOI：
10.1080/16549716.2017.1267964
复制
发表时间：
2017-01-01
影响因子：
2.6
通讯作者：
Benn, Christine Stabell
中科院分区：
文献类型：
--
作者：
Schaltz-Buchholzer, Frederik;Frankel, Hannah Nortoft;Benn, Christine Stabell
背景：减少疫苗浪费很重要。卡介苗 (BCG) 疫苗每瓶生产 20 剂婴儿剂量。重组的疫苗在 4-6 小时后被丢弃。因此，为了减少疫苗浪费，通常只有在至少有 10-12 名婴儿在场的情况下才打开一瓶 20 剂量的 BCG，这会危及 BCG 疫苗接种覆盖率和及时疫苗接种。我们观察到护士无法从小瓶中取出 20 剂疫苗，旨在量化经验丰富的护士在现实情况下可以从这些小瓶中获得多少剂量。 方法：在几内亚比绍国家医院的产科病房，自 2002 年以来，这两名护士一直在出院前为所有符合条件的儿童接种卡介苗。在 2015 年的一个月内，在一项比较 BCG-丹麦和 BCG-俄罗斯的随机试验中，我们记录了护士能够从两种类型的疫苗小瓶中取出的剂量。结果：可以从小瓶中取出的中位数剂量为 13 剂（范围 11-17）：BCG 丹麦为 13 剂（基于 39 瓶）（基于 39 瓶），而 15 剂为 15 剂。 (12-17) 俄罗斯 BCG（基于 29 瓶）。结论：在现实生活中，经验丰富的护士只能从 20 剂瓶中获得 13-15 剂。因此，疫苗浪费比假设的要低得多。根据现实生活中的剂量数量调整实践，如果有 7 个而不是 10 个婴儿，则应立即打开小瓶。正如其他研究表明，卡介苗可能对总体死亡率产生有益的非特异性影响，即使对于一名儿童，打开一瓶 20 剂小瓶的潜在收益也可能相当大。
Background: Reducing vaccine wastage is important. Bacille Calmette-Guerin (BCG) vaccine is produced in vials of 20 infant doses. The reconstituted vaccine is discarded after 4-6 hours. Therefore, to reduce vaccine wastage, a 20-dose vial of BCG is often only opened if at least 10-12 infants are present, jeopardising BCG vaccination coverage and timely vaccination. We observed that nurses were not able to withdraw 20 doses from the vials and aimed to quantify how many doses could be obtained from these vials by experienced nurses under real-life circumstances.Methods: At the maternity ward of the national hospital in Guinea-Bissau, since 2002 the same two nurses have been vaccinating all eligible children with BCG before discharge. During a month in 2015, within a randomised trial comparing BCG-Denmark and BCG-Russia, we registered how many doses the nurses were able to withdraw from the two types of vaccine vials.Results: The median number of doses which it was possible to withdraw from the vials was 13 (range 11-17): 13 (11-16) for BCG-Denmark (based on 39 vials) and 15 (12-17) for BCG-Russia( based on 29 vials).Conclusions: In real life, experienced nurses could only obtain 13-15 doses from the 20-dose vials. Thus, vaccine wastage is much lower than assumed. Adjusting practice to the real-life number of doses would immediately suggest vials should be opened if 7 rather than 10 infants are present. As other studies have indicated that BCG may have beneficial non-specific effects on overall mortality, the potential gain by opening a 20-dose vial even for one child may be considerable.