POST 01092E : VIAL SIZE : A REQUEST FROM GAVI

POST 01092E : VIAL SIZE : A REQUEST FROM GAVI 13 May 2007 _____________________________________ NOTE: Despite innumerable tests, formatting of postings was inappropriate for top and bottom banners. My apologies! These problems have now been resolved. Thank you for your patience. ----------------------- [log in to unmask]">Osman [log in to unmask]">Mansoor from UNICEF is sending this important request, especially for National EPI managers. Your comments are expected by May 21, but if it proves impossible for any of you to respond on time, late reactions will be welcome and considered. _______________________________ Dear Colleagues The GAVI Alliance is seeking guidance on future presentation and packaging requirements for new vaccines to be supported for use in GAVI-eligible countries. The Vaccine Presentation and Packaging Working Group would appreciate getting your opinion as well as any data that can help address this question: "For future injectable pneumococcal vaccine for infant immunization programmes, what is the preferred vial size - in terms of number of doses per vial - for supply to developing countries?" We look forward to your contributions, ideally before 21 May when the working group will hold a teleconference to plan strategies to address the question.. BACKGROUND As the price of new vaccines is ~50 times more than the traditional EPI vaccines, the issue of wastage is correspondingly more important. More doses per vial generally mean more wastage; though effective use of the Multi-Dose-Vial Policy (MDVP) can reduce wastage. Even with 2-dose vials there can still be substantial wastage from unused opened vials. On the other hand the fewer the doses per vial, the greater the cold chain storage and transport requirements, and associated resource needs. The issue is how to balance these two requirements, to provide advice on vial size for developing countries - for expensive new vaccines. QUESTIONS 1. What is the relationship between wastage and number of doses per vial (with and without MDVP)? 2. How do cold chain and logistics costs/requirements vary as a function of storage volume per dose? ASSUMPTIONS AT THIS TIME 1. The vaccine is given as 3-dose series in infancy. (There may also be a catch-up campaign with one dose for all up to age 5 years.) 2. Cost per dose and size of the vial stays about the same, whether it is 1-, 2-, 5-, or 10-dose vial. (The higher cost for a 1-dose vial, is likely to be small compared to overall cost per dose.) 3. Standard cold chain requirements (2°-8°C) are needed for the new vaccines. 4. The MDVP policy may apply to some vaccines but not to others. REQUEST If you have any data on these two questions, or just wish to give your opinion, [log in to unmask]">please send me an email. You may also have an interest in collecting this data, and GAVI may be able to provide support for this. Thank you in anticipation for your help. We will advise Technet of the outcomes of this and other work to help define preferred vial size for the expensive new vaccines. Dr Osman David Mansoor Chair, Vaccine Presentation and Packaging Working Group , GAVI Alliance Senior Adviser EPI (New Vaccines) United Nations Children's Fund ______________________________________________________________________________ All members of the TechNet21 e-Forum are invited to send comments on any posting or to use the forum to raise a new discussion or request technical information in relation to immunization services. The comments made in this forum are the sole responsibility of the writers and do not in any way mean that they are endorsed by any of the organizations and agencies to which the authors may belong. ______________________________________________________________________________ Visit the TECHNET21 Website at http://www.technet21.org You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : [log in to unmask]">[log in to unmask] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de coopération internationale en santé et développement, Québec, Canada (www.ccisd.org ______________________________________________________________________________