One size does not fit all: The impact of primary vaccine container size on vaccine distribution and delivery

Leila A. Haidari; Brian Wahl; Shawn T. Brown; Lois Privor-Dumm; Cecily Wallman-Stokes; Katie Gorham; Diana L. Connor; Angela R. Wateska; Benjamin Schreiber; Hamadou Dicko; Philippe Jaillard; Melanie Avella; Bruce Y. Lee

doi:10.1016/j.vaccine.2015.04.018

One size does not fit all: The impact of primary vaccine container size on vaccine distribution and delivery

Leila A. Haidari, Brian Wahl, Shawn T. Brown, Lois Privor-Dumm, Cecily Wallman-Stokes, Katie Gorham, Diana L. Connor, Angela R. Wateska, Benjamin Schreiber, Hamadou Dicko, Philippe Jaillard, Melanie Avella, Bruce Y. Lee

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

Background: While the size and type of a vaccine container (i.e., primary container) can have many implications on the safety and convenience of a vaccination session, another important but potentially overlooked consideration is how the design of the primary container may affect the distribution of the vaccine, its resulting cost, and whether the vial is ultimately opened. Methods: Using our HERMES software platform, we developed a simulation model of the World Health Organization Expanded Program on Immunization supply chain for the Republic of Benin and used the model to explore the effects of different primary containers for various vaccine antigens. Results: Replacing vaccines with presentations containing fewer doses per vial reduced vaccine availability (proportion of people arriving for vaccines who are successfully immunized) by as much as 13% (from 73% at baseline) and raised logistics costs by up to $0.06 per dose administered (from $0.25 at baseline) due to increased bottlenecks, while reducing total costs by as much as $0.15 per dose administered (from $2.52 at baseline) due to lower open vial wastage. Primary containers with a greater number of doses per vial each improved vaccine availability by 19% and reduced logistics costs by $0.05 per dose administered, while reducing the total costs by up to $0.25 per dose administered. Changes in supply chain performance were more extreme in departments with greater constraints. Implementing a vial opening threshold reversed the direction of many of these effects. Conclusions: Our results show that one size may not fit all when choosing a primary vaccine container. Rather, the choice depends on characteristics of the vaccine, the vaccine supply chain, immunization session size, and goals of decision makers. In fact, the optimal vial size may vary among locations within a country. Simulation modeling can help identify tailored approaches to improve availability and efficiency.

Original language	English (US)
Pages (from-to)	3242-3247
Number of pages	6
Journal	Vaccine
Volume	33
Issue number	28
DOIs	https://doi.org/10.1016/j.vaccine.2015.04.018
State	Published - Jun 22 2015

Keywords

Immunization
Simulation modeling
Supply chain
Vial size

ASJC Scopus subject areas

Molecular Medicine
General Immunology and Microbiology
General Veterinary
Public Health, Environmental and Occupational Health
Infectious Diseases

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10.1016/j.vaccine.2015.04.018

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Haidari, L. A., Wahl, B., Brown, S. T., Privor-Dumm, L., Wallman-Stokes, C., Gorham, K., Connor, D. L., Wateska, A. R., Schreiber, B., Dicko, H., Jaillard, P., Avella, M., & Lee, B. Y. (2015). One size does not fit all: The impact of primary vaccine container size on vaccine distribution and delivery. Vaccine, 33(28), 3242-3247. https://doi.org/10.1016/j.vaccine.2015.04.018

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abstract = "Background: While the size and type of a vaccine container (i.e., primary container) can have many implications on the safety and convenience of a vaccination session, another important but potentially overlooked consideration is how the design of the primary container may affect the distribution of the vaccine, its resulting cost, and whether the vial is ultimately opened. Methods: Using our HERMES software platform, we developed a simulation model of the World Health Organization Expanded Program on Immunization supply chain for the Republic of Benin and used the model to explore the effects of different primary containers for various vaccine antigens. Results: Replacing vaccines with presentations containing fewer doses per vial reduced vaccine availability (proportion of people arriving for vaccines who are successfully immunized) by as much as 13% (from 73% at baseline) and raised logistics costs by up to $0.06 per dose administered (from $0.25 at baseline) due to increased bottlenecks, while reducing total costs by as much as $0.15 per dose administered (from $2.52 at baseline) due to lower open vial wastage. Primary containers with a greater number of doses per vial each improved vaccine availability by 19% and reduced logistics costs by $0.05 per dose administered, while reducing the total costs by up to $0.25 per dose administered. Changes in supply chain performance were more extreme in departments with greater constraints. Implementing a vial opening threshold reversed the direction of many of these effects. Conclusions: Our results show that one size may not fit all when choosing a primary vaccine container. Rather, the choice depends on characteristics of the vaccine, the vaccine supply chain, immunization session size, and goals of decision makers. In fact, the optimal vial size may vary among locations within a country. Simulation modeling can help identify tailored approaches to improve availability and efficiency.",

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AU - Brown, Shawn T.

AU - Privor-Dumm, Lois

AU - Wallman-Stokes, Cecily

AU - Gorham, Katie

AU - Connor, Diana L.

AU - Wateska, Angela R.

AU - Schreiber, Benjamin

AU - Dicko, Hamadou

AU - Jaillard, Philippe

AU - Avella, Melanie

AU - Lee, Bruce Y.

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One size does not fit all: The impact of primary vaccine container size on vaccine distribution and delivery

Abstract

Keywords

ASJC Scopus subject areas

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