Short supply of vaciines requiring multiple doses is one of the causes of accentuating negeative dropout rate, making the indicator invalid for programme review.
India introduced two fractional doses of 0.1mL intra-dermal IPV in the National Immunization Schedule (NIS) since April 2016 as an end game strategy of Polio Eradication. It is supplied as multi dose vial of 50 doses per vial [0.1mL per dose – 5mL vial] & 25 doses [0.1mL per dose – 2.5mL].
From the first experiences of the first 5 vials we learnt that 61.6% doses were sacrificed [154 doses were sacrificed out of 250 doses in 5 vials]. Soon we received 25 doses per vial and the wastage became NIL [0%] in the CHC and Medical College.
This month we again got 50 doses per vial. With this, to minimize “sacrificing” of precious vaccine and being supported by the midlevel managers, 3 Aces [ANMs, AWWs and ASHAs] stared mobilizing all those who are below one year and missed IPV due to short supply.
With this ‘movement’ of clearing the backlog to close population immunity gap & to make optimum use of the vaccine, we observed that first dose IPV administered along with 3rd dose of OPV and Pentavalent was recorded in the ‘cell’ meant for IPV 2nd dose. This will give an accentuated negative IPV1 & IPV2 dropout.
India is unique for unity in diversity. In the past, similar errors occurred when OPV supply was inadequate in 2012 in Jharkhand.
Solution: Sustained Supportive Supervision, hands on orientation, learning by doing and working together approach by the supervisors, technical assistants and development partners goes a long way in quality data maintenance and programme implementation.
The attached illustration is shared and the viewers may get similar observations in the field.
Holla and the team