TechNet-21 - Forum

This forum provides a place for members to ask questions, share experiences, coordinate activities, and discuss recent developments in immunization.
  1. Samir Sodha
  2. Programme management
  3. Wednesday, 09 March 2022

When: Tuesday, March 15, 2022 3:30PM - 4:30PM (CET)


Registration Link: 


• Sheldon Halsted, Linksbridge
• Robert Steinglass (formerly JSI and supported study in Zambia)


There is an abundance of evidence that healthcare workers hesitate to open 10-dose vials of measles containing vaccine (MCV) because of concerns about open-vial wastage and vaccine stock-outs at facility level, and that this contributes to missed opportunities for vaccination (MOV). Studies have demonstrated that the use of MCV 5-dose vials can address this barrier to more responsive immunization services and increase vaccination coverage because healthcare workers are less reluctant to open the smaller vial.

Implementation research conducted in Zambia found that the 5-dose vial intervention increased MCV1 coverage by 4.9 percentage points and MCV2 coverage by 3.5 percentage points, and that the wastage rate was 47% lower in facilities using 5-dose vials versus 10-dose vials (Krudwig et al., 2020). Stakeholders are aligned that the MCV 5-dose vial offers a clear opportunity to increase measles vaccine coverage and equity, with minimal and manageable risks. And yet, despite expert alignment, positive evidence of cost-effectiveness, and unrestricted supply, uptake of MCV 5-dose vials has been slow to-date. Throughout 2021, and in collaboration with measles stakeholders, we built upon the results of the Zambia study to assess the opportunities for introducing MCV 5-dose vials and the current knowledge and awareness gaps in order to align on collective next steps.

In this session, we hope to share the outputs of this work:

1. Present results from total systems effectiveness (TSE) analysis which assesses the potential public health impact of adopting measles 5-dose vials

2. Summarize findings from workshops and interviews with measles experts in the field and across a range of public health organizations—including the Bill & Melinda Gates Foundation, Gavi, WHO, UNICEF, MSF, and the CDC

3. Provide an overview of partner-agreed next steps and key actions that will help enable country uptake of 5-dose vials

The Zero-dose approach in Gavi5.0 and IA2030 is about reaching unvaccinated children and ensuring that they receive all the vaccines in their national schedules. Reaching more zero-dose children with first doses while leaving them vulnerable to measles because they do not complete the vaccination schedule would be a failure for the zero-dose initiative. The goal is to increase the Fully Immunized Children (FIC) at the same pace as the number of unvaccinated zero-dose children falls. Achieving that goal demands that the programmatic focus is not only on reaching the zero-dose children with first doses, but also on making sure that they complete their vaccinations. This will require a string of interventions along the path to full protection against vaccine preventable diseases. Measles killed more than 200,000 children in 2019 and halting the transmission of measles virus is a top priority for improving child survival and reaching the child health related SDG targets. 

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