Impact of changing the measles vaccine vial size on Niger's vaccine supply chain: a computational model
Impact of changing the measles vaccine vial size on Niger's vaccine supply chain: a computational model
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DOI：
10.1186/1471-2458-11-425
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发表时间：
2011-06-02
影响因子：
4.5
通讯作者：
Lee, Bruce Y.
中科院分区：
文献类型：
--
作者：
Assi, Tina-Marie;Brown, Shawn T.;Lee, Bruce Y.
背景资料：尼日尔等许多国家正在考虑改变其疫苗小瓶规格说明，并可能希望评估随后对其供应链的影响，即将疫苗从其制造商提供给患者所需的一系列步骤。麻疹疫苗是特别重要的尼日尔，一个国家容易发生麻疹outbreaks.Methods的：我们开发了一个详细的离散事件模拟模型的疫苗供应链代表每一个疫苗，存储位置，冰箱，冰柜，和运输设备（例如。例如，在一个实施例中，冷藏车、四轮驱动卡车和疫苗运输车）。实验模拟的影响，取代10剂麻疹瓶大小与5剂，2剂和1剂的小瓶sizes.Results：切换从10剂到5剂，2剂和1剂的小瓶尺寸减少了平均可用性的计划免疫疫苗到达患者从83%到82%，81%和78%，分别为100%的目标人口规模。开关也改变了运输车辆的利用率从平均58%（范围：4-164%）至平均值59%（范围：4-164%），62%（范围：4-175%）和67%（范围：5-192%），分别在区域和地区商店之间，平均为160%地区与综合保健中心之间的平均值分别为161%（范围：82-322%）、175%（范围：78-344%）和198%（范围：88-402%）。该转换还将地区级存储利用率从平均65%更改为平均64%、66%和68%（所有场景的范围：3-100%）。最后，考虑到疫苗接种、浪费和处置，用5剂或1剂小瓶取代10剂小瓶将使每个免疫患者的成本分别从0.47美元增加到0.71美元和1.26美元。从10-将麻疹疫苗剂量缩小到小瓶尺寸可能会使许多储存设施和运输车辆不堪重负，接种疫苗的孩子
Background: Many countries, such as Niger, are considering changing their vaccine vial size presentation and may want to evaluate the subsequent impact on their supply chains, the series of steps required to get vaccines from their manufacturers to patients. The measles vaccine is particularly important in Niger, a country prone to measles outbreaks.Methods: We developed a detailed discrete event simulation model of the vaccine supply chain representing every vaccine, storage location, refrigerator, freezer, and transport device (e. g., cold trucks, 4 x 4 trucks, and vaccine carriers) in the Niger Expanded Programme on Immunization (EPI). Experiments simulated the impact of replacing the 10-dose measles vial size with 5-dose, 2-dose and 1-dose vial sizes.Results: Switching from the 10-dose to the 5-dose, 2-dose and 1-dose vial sizes decreased the average availability of EPI vaccines for arriving patients from 83% to 82%, 81% and 78%, respectively for a 100% target population size. The switches also changed transport vehicle's utilization from a mean of 58% (range: 4-164%) to means of 59% (range: 4-164%), 62% (range: 4-175%), and 67% (range: 5-192%), respectively, between the regional and district stores, and from a mean of 160% (range: 83-300%) to means of 161% (range: 82-322%), 175% (range: 78-344%), and 198% (range: 88-402%), respectively, between the district to integrated health centres (IHC). The switch also changed district level storage utilization from a mean of 65% to means of 64%, 66% and 68% (range for all scenarios: 3-100%). Finally, accounting for vaccine administration, wastage, and disposal, replacing the 10-dose vial with the 5 or 1-dose vials would increase the cost per immunized patient from $0.47US to $0.71US and $1.26US, respectively.Conclusions: The switch from the 10-dose measles vaccines to smaller vial sizes could overwhelm the capacities of many storage facilities and transport vehicles as well as increase the cost per vaccinated child.