Health Care Worker Preferences and Perspectives on Doses per Container for 2 Lyophilized Vaccines in Senegal, Vietnam, and Zambia

Kanagat, Natasha; Krudwig, Kirstin; Wilkins, Karen; Kaweme, Sydney; Phiri, Guissimon; Mwansa, Frances D.; Mvundura, Mercy; Robertson, Joanie; Kristensen, Debra; Gueye, Abdoulaye; Dao, Sang; Thai, Pham Quang; Nguyen, Hoai-Son; Tran, Thang C.

doi:10.9745/ghsp-d-20-00112

Cited by 11 publications

(7 citation statements)

References 7 publications

(6 reference statements)

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“…It is therefore important that health workers' training includes the EPI policy of opening a multi-dose vial, even for one eligible child. Additionally, having measles vaccine in smaller vials could also reduce MOV [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Missed opportunities for vaccination among children aged 0–23 months visiting health facilities in a southwest State of Nigeria, December 2019

et al. 2021

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Background Despite efforts to improve childhood immunization coverage in Nigeria, coverage has remained below the national acceptable level. In December 2019, we conducted an assessment of Missed Opportunities for Vaccination (MOV) in Ondo State, in Southwest Nigeria. The objectives were to determine the magnitude of, explore the reasons for, as well as possible solutions for reducing MOV in the State. Methods This was a cross-sectional study using a mixed-methods approach. We purposively selected 66 health facilities in three local government authorities, with a non-probabilistic sampling of caregivers of children 0–23 months for exit interviews, and health workers for knowledge, attitudes, and practices (KAP) surveys. Data collection was complemented with focus group discussions and in-depth interviews with caregivers and health workers. The proportion of MOV among children with documented vaccination histories were determined and thematic analysis of the qualitative data was carried out. Results 984 caregivers with children aged 0–23 months were interviewed, of which 869 were eligible for inclusion in our analysis. The prevalence of MOV was 32.8%. MOV occurred among 90.8% of children during non-vaccination visits, and 7.3% during vaccination visits. Vaccine doses recommended later in the immunization series were given in a less timely manner. Among 41.0% of health workers, they reported their vaccination knowledge was insufficient. Additionally, 57.5% were concerned about and feared adverse events following immunization. Caregivers were found to have a low awareness about vaccination, and issues related to the organization of the health system were found to contribute towards MOV. Conclusions One in three children experienced a MOV during a health service encounter. Potential interventions to reduce MOV include training of health workers about immunization policies and practices, improving caregivers’ engagement and screening of vaccination documentation by health workers during every health service encounter.

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Section: Discussionmentioning

confidence: 99%

Missed opportunities for vaccination among children aged 0–23 months visiting health facilities in a southwest State of Nigeria, December 2019

et al. 2021

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“…Furthermore, these access issues may negatively affect vaccine acceptance, as parents actively trying to get their child vaccinated with the measles vaccine turn away when the provider refuses to open the measles vaccine vial [13][14][15][16][17]28,29]. Evidence from some African countries suggests that changing the number of doses per vials from 10 to 5 would double the number of opportunities to open a vial compared to its presentation in 10-dose vials [49][50][51][52]. We suggest that an analysis of the immunization policy as well as cost-effective analysis is needed to anticipate what will happen if the 10-dose vial of measles vaccine (i.e., open-vial policy) is shifted to a 5-dose vial in Sudan as it has succeeded in many LMIC countries [49][50][51].…”

Section: Discussionmentioning

confidence: 99%

“…Evidence from some African countries suggests that changing the number of doses per vials from 10 to 5 would double the number of opportunities to open a vial compared to its presentation in 10-dose vials [49][50][51][52]. We suggest that an analysis of the immunization policy as well as cost-effective analysis is needed to anticipate what will happen if the 10-dose vial of measles vaccine (i.e., open-vial policy) is shifted to a 5-dose vial in Sudan as it has succeeded in many LMIC countries [49][50][51].…”

Section: Discussionmentioning

confidence: 99%

Vaccine Hesitancy among Parents and Its Association with the Uptake of Measles Vaccine in Urban Settings in Khartoum State, Sudan

et al. 2022

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Vaccine uptake is one of the indicators that has been used to guide immunization programs. This study aimed to evaluate whether measles vaccine uptake is predicted by measles vaccine hesitancy. A community-based cross-sectional study was conducted in urban districts in Khartoum state in February 2019. Measles vaccine uptake among children was measured as either fully vaccinated or partially/not vaccinated. The Parent Attitudes about Childhood Vaccines (PACV) scale was used to measure measles vaccine hesitancy. Multivariate logistic regression was run to identify the predictors of measles vaccination uptake, controlling for sociodemographic variables, and the adjusted odds ratios (aORs) with 95% CI were calculated. The receiver operator characteristic (ROC) curve was created, and the area under the curve (AUC) for the PACV was computed. Data were collected from 495 participants. We found that measles vaccine hesitancy (PACV scores) predicts the uptake of measles vaccine after controlling for other potential social confounders, such as the mother’s age and the number of children (aOR 1.055; 95% CI 1.028–1.028). Additionally, the ROC for the PACV yielded an area under the curve (AUC 0.686 (95% CI 0.620–0.751; p < 0.001)). Our findings show that measles vaccine hesitancy in Sudan directly influences the uptake of the measles vaccine. Addressing the determinants of vaccine hesitancy through communication strategies will improve vaccine uptake.

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“…When deciding which vaccines to use in their immunization program, countries may tend to focus on clinic-level factors, such as open vial wastage, [ 32 - 34 ] and fail to see the broader systems-wide effects (e.g., how a vaccine’s size may constrain storage space for other vaccines). By taking a systems approach and looking at the supply chain as a whole, we show that while wastage does increase when switching to multi-dose vials, the reductions in cold chain utilization have a net positive effect on the availability of all vaccines and the costs per dose administered.…”

Section: Discussionmentioning

confidence: 99%

Should countries switch to using five- or ten-dose rotavirus vaccines now that they are available?

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et al. 2021

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Health Care Worker Preferences and Perspectives on Doses per Container for 2 Lyophilized Vaccines in Senegal, Vietnam, and Zambia

Cited by 11 publications

References 7 publications

Missed opportunities for vaccination among children aged 0–23 months visiting health facilities in a southwest State of Nigeria, December 2019

Missed opportunities for vaccination among children aged 0–23 months visiting health facilities in a southwest State of Nigeria, December 2019

Vaccine Hesitancy among Parents and Its Association with the Uptake of Measles Vaccine in Urban Settings in Khartoum State, Sudan

Should countries switch to using five- or ten-dose rotavirus vaccines now that they are available?

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