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Rationalising vaccine delivery - A fully liquid DTP-HepB-Hib vaccine
- Vaccine delivery time-and-motion study, Calcutta, India (Photo K. Wiedenmayer)
Immunisation against childhood communicable diseases is among the most cost-effective public health interventions and is essential to achieve the Millennium Development Goal of reducing child mortality. Fully liquid combination vaccines have been developed to rationalize vaccine delivery and to simplify supply and administration of vaccines. A fully liquid DTP-HepB-Hib vaccine offers advantages, and including it in national immunization programmes might prove to be an optimal use of resources.
A time-motion study was conducted in Calcutta, India, to understand implications of a fully liquid pentavalent DTPHepB-Hib vaccine in terms of resource requirements, efficiency and impact on vaccination programmes. The study compared a single fully liquid DTP-HepB-Hib vaccine with a lyophilised vaccine presented in two vials requiring reconstitution. Study results indicated significant time savings for vaccine preparation and total vaccine consultation for the fully liquid vaccine of 52 and 23%. Extrapolated to India, delivery time savings could be around 100,000 working days per year, and savings could be up to USD 50 million per year.
Based on these results, an economic model was developed to assess potential financial and economic implications of replacing the currently used DTP-Hib plus HepB vaccines with a fully liquid DTP-HepB-Hib vaccine in the national immunisation programme of South Africa.
Results indicated that total potential savings would be around USD 2.5 million per year. These savings hide more important economic benefits such as the reduction of over 7,000 health worker working days yearly in a country with a critical shortage of health workers.
Currently, an economic appraisal for introducing Hib antigen into the national EPI of Egypt is ongoing. Introduction of a new vaccine must be based on solid evidence of cost-effectiveness in a country with limited resources. Based on available data, the potential cost of a new vaccine, benefits and savings related to reduced burden of disease and resource implications are calculated.
Results of these studies have been presented at the International Congress of Infectious Disease, the World Society of Pediatric Infectious Disease, the Egyptian Society for Pediatric Allergy and Immunology and the Geneva Health Forum.