A new article from an intervention study conducted by the Ministry of Health in Zambia looked at the effect of switching from 10 to 5-dose vials of MR vaccine. The Dose per Container Partnership for this study has been key, with results showing that a switch from 10-dose to 5-dose MR vials increases routine vaccination coverage rate (5 percentage-point intervention effect was detected for MCV1 and 3.5 percentage-point effect for MCV2), and reduces wastage by 41% (16.2% wastage rate in facilities using 5-dose vials compared to 30.5% with 10-dose vials). The researchers found practically no difference in wastage-adjusted purchase price per dose and negligible effect on the cold chain. Healthcare workers reported being more willing to open a 5-dose vial than a 10-dose vial for one child, as they were less concerned about wastage.
The research findings are timely given the recent World Health Organization COVID-19 guidance recommending frequent routine immunization sessions of smaller size. Use of 5-dose M or MR vials is potentially a practical, doable innovation that can introduce some resilience into the health system, influence health worker behavior, reduce missed opportunities, and encourage parents by offering all needed vaccinations on scheduled vaccination days and opportunistically on non-scheduled days.
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