POST 00615E : SINGLE-DOSE VERSUS MULTI-DOSE

POST 00615E : SINGLE-DOSE VERSUS MULTI-DOSE Follow-up on Post 00613E 17 November 2003 ____________________________ Following the posting of the article "Single-dose versus multi-dose vaccine vials....." in Post 00613E, Femi Oyewole (mailto:[log in to unmask]) from WHO in Ethiopia and Alozie Ananaba (mailto:[log in to unmask]) from Nigeria both share their reactions. ____________________________ The paper on "Single-dose versus multi-dose" made very interesting reading. It calls for us to become "masters of the balancing act". I stand to be corrected, but I think where the single-dose vaccines are mostly needed- places with high vaccine wastage, places where outreach services are required- are the same areas where cold chain capacities are less than adequate and economy is poor. While I agree that the heat-stable vaccines will benefit from the single-dose option, can we put in place a system where these vaccines can be shipped "in instalments" to the countries taking into consideration the holding capacity of their cold chain and of course the next question will be - what will be the financial implications and who picks up the tab? Please advise. Femi Oyewole, Epidemiologist, WHO/EPI Ethiopia _____________________________________________ Regards. The issue in discourse is one that has far reaching implications on the eventual targets of immunization programmes. Comments will generally be relative depending on what the current practises are in the various countries. Here in Nigeria south east zone a lot of other services are tied directly or indirectly to immunization services. Immunization opportunities serve as the greatest stimulus for utilization of Primary Health Care Services in this area. Mothers that make themselves available for immunization clinics are more likely to seek help at those centres if other health conditions do occur. Experience has shown that the use of multi-dose vials affords the delivery outlets only once a month -opportunities to get these vaccines to children- to avoid wastage. Mothers who present children who are eligible for vaccination are sent back to come on a date that the provider assumes enough clients would have accumulated for the multi-dose regimes. Of course in an environment with poor health-seeking attitude, this is a missed opportunity. Single dose vials will in the long run improve on coverage levels of the vaccines - the main objective of the programme. Thanks, DR A O ANANABA ____________________________ ______________________________________________________________________________ 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 : mailto:[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 (http://www.ccisd.org) ______________________________________________________________________________