POST 00613E : SINGLE-DOSE VERSUS MULTI-DOSE 5 November 2003
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Attached is a very interesting article, "Single-dose versus multi-dose
vaccine vials for immunization programmes in developing countries" by Paul
K. Drain, Carib M. Nelson and John S. Lloyd, from PATH. Recently published
in the "Bulletin of the World Health Organization, volume 81", it discusses
differences between single-dose and multi-dose formats and their respective
programmatic and economic benefits. Based on this discussion it offers
recommendations for making the most appropriate selection. Below is the
abstract which is also presented in French and Spanish at the end of the
article.
If you have any problem downloading the article it can also be accessed
from the WHO site at :
http://www.who.int/bulletin/volumes/81/10/en/Drain1003.pdf
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Excessive vaccine wastage and safety concerns have prompted the
international health community to develop and supply vaccines in formats
other than the standard multi-dose vial. This article presents a
programmatic and economic comparison of the major differences between the
multi-dose vials and single-dose formats used for immunization services in
developing countries.
Multi-dose vials, in general, sell at a lower per-dose price and occupy
less cold-chain capacity than single-dose formats. However, higher wastage
rates may offset these benefits, especially for more expensive vaccines.
Single-dose formats offer several important programmatic benefits, such as
increased vaccination opportunities and improved vaccine safety. One
single-dose format, the prefilled auto-disable (AD) device, provides
additional injection safety and convenience features because it physically
combines the vaccine and AD syringe.
Selecting the appropriate vaccine presentation will depend on many factors.
However, multi-dose vials are likely to be most appropriate for cheaper
vaccines and in settings where cold-chain storage capacity is restricted.
Single-dose formats will be most appropriate for more expensive vaccines
and where there are problems with unsafe injection practices. Prefilled AD
injection devices will be particularly useful in expanding outreach
services while eliminating the possibility of needle reuse.
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