RT Journal Article
SR Electronic
T1 Health Care Worker Preferences and Perspectives on Doses per Container for 2 Lyophilized Vaccines in Senegal, Vietnam, and Zambia
JF Global Health: Science and Practice
JO GLOB HEALTH SCI PRACT
FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs
SP 680
OP 688
DO 10.9745/GHSP-D-20-00112
VO 8
IS 4
A1 Kanagat, Natasha
A1 Krudwig, Kirstin
A1 Wilkins, Karen A.
A1 Kaweme, Sydney
A1 Phiri, Guissimon
A1 Mwansa, Frances D.
A1 Mvundura, Mercy
A1 Robertson, Joanie
A1 Kristensen, Debra
A1 Gueye, Abdoulaye
A1 Dao, Sang D.
A1 Thai, Pham Q.
A1 Nguyen, Huyen T.
A1 Tran, Thang C.
YR 2020
UL http://www.ghspjournal.org/content/8/4/680.abstract
AB Key FindingsHealth care workers (HCWs) in all 3 countries preferred containers with fewer doses for reconstituted vaccines such as BCG and measles-containing vaccine.HCWs believed that containers with fewer doses of these vaccines could reduce wastage and missed vaccination opportunities.HCWs were more willing to open a vial for every eligible child when using containers with fewer doses.Key ImplicationsPolicy makers should consider HCW perspectives when deliberating a change in policy on vial size since HCWs have to balance concerns about open vial wastage with the guidance to open a vial to vaccinate every eligible child.Program managers should consider shifting to containers with fewer doses for vaccines without preservatives to assuage HCW concerns about opening vials for every eligible child while managing wastage.Introduction:Limited information exists on health care workers’ (HCWs) perceptions about use of multidose vaccine vials and their preferences about doses per container (DPC). We present findings from qualitative studies conducted in Senegal, Vietnam, and Zambia to explore HCWs’ behavior regarding opening vials and their perceptions and preferences for the number of doses in vials of BCG and measles-containing vaccine (MCV). Zambia and Senegal currently offer MCV in 10-dose vials and BCG in 20-dose vials; 10-dose vials are used for both vaccines in Vietnam. Unused doses in vials of these reconstituted vaccines must be discarded within 6 hours.Methods:Key informant interviews (KIIs) were conducted with frontline HCWs in Senegal, Vietnam, and Zambia. In Senegal and Vietnam, the KIIs were conducted as part of broader formative research; in Zambia, KIIs were conducted in control districts using 10-dose MCV vials only and in intervention districts that switched from 10- to 5-dose vials during the study. During analysis, themes common to all 3 countries were synthesized. Critical themes relevant to country contexts were also examined.Results:HCWs in all 3 countries preferred containers with fewer doses for BCG and MCV to reduce wastage and increase the likelihood of vaccinating every eligible child. HCWs in Senegal and HCWs using 10-dose vials in Zambia reported sending unvaccinated children away because not enough children were present to warrant opening a new vial. In Vietnam, where sessions are typically held monthly, and in Zambia when the 5-dose vials were used, almost all HCWs reported opening a vial of MCV for even 1 child.Discussion:HCWs prefer vials with fewer DPC. Their concerns about balancing coverage and wastage influence their decisions to vaccinate every eligible child; and their perspectives are crucial to ensuring that all target populations are reached with vaccines in a timely manner.