Frequency and causes of vaccine wastage
Frequency and causes of vaccine wastage
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DOI：
10.1016/s0264-410x(01)00433-9
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发表时间：
2002-01-15
期刊：
影响因子：
5.5
通讯作者：
Weniger, BG
中科院分区：
文献类型：
--
作者：
Setia, S;Mainzer, H;Weniger, BG
评估疫苗浪费的频率及其各种原因的相对严重程度，可能有助于有针对性地努力减少这些损失，并节省用于日益昂贵的疫苗的资金。研究方法：作为对美国浪费情况的初步概述，1998年和1999年对64个公共部门、州和地方卫生部门的免疫规划进行了浪费记录调查。实际浪费数据是从五个州的非随机子集收集的。从常规的国家生物制剂监测和一项特别调查中分析了废弃疫苗返回生产商的数据。审查了1994年至1999年这类报税表的消费税抵免请求。结果如下：1998年，五个州的浪费率约为1%至5%，1999年，57个免疫方案的总浪费率为2.6%。卫生部门使用的浪费类别差别很大，分类重叠。主要原因似乎是冷藏（冷链）失效，其次是过期。疫苗的总体退货率因生产商而异，最高可达8%，因疫苗类型而异，从1%到50%不等，通常较少使用的疫苗的退货率较高。结论：如果这些1-5%的浪费估计数适用于全国，1998年仅在公共部门就有价值约600 - 3100万美元的未使用疫苗。两种最常见的浪费形式揭示了开发具有改进的热稳定性和更长保质期的疫苗的潜在价值。我们提出了六种主要的疫苗浪费分类，用于常规监测和报告，由Elsevier Science Ltd.出版。
Assessing the frequency of vaccine wastage and the relative magnitude of its various causes may help to target efforts to reduce these losses and to husband funds for increasingly expensive vaccines. Methods: As a preliminary overview of wastage in the United States, 64 public-sector state and local health department immunization programs were polled in 1998 and 1999 for wastage recording practices. Actual wastage data were collected from a non-random subset of five states. Data on returns of wasted vaccine to manufacturers were analyzed from routine national biologics surveillance and from an ad-hoc survey. Excise tax credit requests for such returns between 1994 and 1999 were reviewed. Results: Rates of wastage among the five states ranged from about 1 to 5% in 1998, with an overall rate of 2.6% among 57 immunization programs in 1999. Categories of wastage used by the health departments varied widely, with overlapping classifications. The major causes appeared to be refrigeration (cold chain) lapses, followed by expiration. Overall rates of vaccine returns varied up to 8% by manufacturer, and from 1 to 50% by vaccine type, with higher return rates generally found for lesser-used vaccines. Conclusions: If these wastage estimates of 1-5% applied nationally, in 1998 there would have been approximately US$ 6-31 million worth of unused vaccine in the public sector alone. The two most common forms of wastage reveal the potential value of developing vaccines with improved heat stability and longer shelf lives. We propose six main classifications of vaccine wastage for use in routine monitoring and reporting, Published by Elsevier Science Ltd.