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

Senegal: MCV, BCG, and yellow fever vaccines were not offered every time immunization sessions were held. During immunization sessions, HCWs reported that they waited for a minimum number of children before opening these vaccines. HCWs recalled turning away a caregiver and child at least once in the past 3 months.

Vietnam: Due to Vietnam’s session schedules, which are mostly once a month, most HCWs did not wait for a minimum number of children before opening vials. They did not recall turning away children in the past 3 months.

Zambia: In the districts using the 10-dose vials, HCWs waited for a minimum of 5 children to open an MCV vial and 10 children to open a 20-dose BCG vial. In the districts using the 5-dose vials, HCWs opened a vial each time an eligible child presented and did not report turning away a child.

In all 3 countries, although coverage was considered more important, HCWs reported that wastage was tracked very closely and they knew they had to minimize wastage as much as possible.

In Zambia and Senegal, HCWs did not offer MCV, BCG, or yellow fever vaccines (Senegal only) at every session due to concerns about wastage. The intent was to increase session sizes for these specific vaccines as a way of reducing open vial wastage.

In the facilities offering 5-dose vials in Zambia, HCWs believed that their wastage was lower, and they expressed less concern about opening the vial for fewer children compared with the facilities using the 10-dose vials.

All HCWs expressed a preference for fewer DPC for BCG and MCV (and yellow fever for Senegal) to allow them to vaccinate eligible children, prevent dropouts, and not worry about wastage.

No HCWs in the districts in Zambia that used the 5-dose vials during implementation wanted to return to using the 10-dose vials.