Pourquoi des flacons de vaccins plus petits pourraient aider la Zambie à étendre la couverture vaccinale contre la rougeole
Smaller Vaccine vials Lead to Big Gains in Zambian Immunization Efforts
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Mwimba, Zambia - Nurse Memory Mwezi has worked at the Mwimba Health Post long enough to anticipate the ebb adn flow of patient needs.Fridays are typically quiet at this small public health facility in Zambia’s eastern Lumezi district.
But this particular Friday, being the frist of the month, was unusually busy. “people tend to come at the beginning or end of the month,” Mwezi explained once the crowd of young patients and their caregivers had thinned.
The clinic serves children from newborns to five years old, and Mwezi spent the morning administering a series of vaccines as part of Zambia’s routine immunization schedule. But I was there to ask about one vaccine in particular – and for a reason that seems deceptively simple.
A Small Change with Big Potential
last year, Zambia began using measles and rubella (MR) vaccines in a new format. Instead of the usual ten-dose vials containing the measles-rubella combination,health centers,including the Mwimba Health Post,started stocking five-dose vials. Studies suggested that this seemingly small change could have a notable impact.I wanted to know if Mwezi was seeing signs of that change.
“it’s common for us to have two to four children needing the measles vaccine on certain days,” she shared. “When we were still using the ten-dose vials, I often had to send people home, especially when supplies were limited.”
Once opened, vaccine vials cannot be resealed and stored, meaning opening a ten-dose measles vaccine vial to vaccinate two children woudl result in the loss of eight doses.
“While the World Health Association (WHO) and Zambia’s health system recommend opening vials even for a single child to ensure maximum protection, healthcare workers are often hesitant to waste vaccines, particularly when supplies are scarce,” Mwezi explained.
“But this meant we risked missing patients who we asked to return on days with higher turnout.Coverage wasn’t optimal. But that changed with the five-dose vials,” she said.
Smaller Vaccine Vials Boost Vaccination Rates in Zambia
Health workers in Zambia are reporting increased vaccination rates thanks to the introduction of smaller vaccine vials. The new vials, containing five doses instead of the traditional ten, are proving to be a game-changer in remote areas where access to healthcare is limited.
Memory Mwezi, a nurse at a health post in rural zambia, has witnessed firsthand the positive impact of the smaller vials. “Before, we were hesitant to open a ten-dose vial unless we had enough children present to use all the doses,” she explained.”We were worried about wasting precious vaccine. Now,with the five-dose vials,we can vaccinate even a few children without fear of wastage. It’s a huge relief, and our vaccination coverage numbers are improving.”
Mwezi has also noticed a shift in community outreach efforts. Mobile vaccination sessions are now being held in more remote and hard-to-reach areas within the district. “We have more stock with the five-dose vials, so I’m not afraid to open a vial even if there are fewer than five patients present,” she said. “It’s a relief because our coverage rates are better.”
Rahab Mbewe, an environmental health technologist at the Chanyalubwe Health Post in eastern Zambia, echoed Mwezi’s experience. mbewe’s work includes monitoring health programs, and she vividly remembers a time when the larger vials presented a challenge.
“We were conducting outreach vaccination at a location 32 kilometers from the health post,” she recalled. “We had 21 eligible children – ten for the second dose of the measles vaccine and eleven for the first dose. We vaccinated 20 children without any problem using two vials, but there was one child left who needed the second dose of the measles vaccine.”
The team had to ask the mother to wait until more children arrived to open another vial. “we couldn’t guarantee that more children would come because it was quite late in the day,” Mbewe explained.
The child wasn’t vaccinated that day, but Mbewe, who also works with a team that follows up on unvaccinated children, advised the mother to visit the health center on routine vaccination days. ”In this case, the mother was able to make it to the facility, but imagine a situation where the mother couldn’t afford to travel,” she continued. “This wasn’t an isolated incident – children were missing out on vaccinations because we were afraid of wasting doses. If you have one child at the opening of a ten-dose vial, there’s a chance that three or four more children might show up within the six-hour window when the vial is still viable.”
The Zambian Ministry of Health began rolling out the five-dose vials nationwide in 2023, but the country had been piloting the new presentation in select districts as 2017. These districts and the experiences of healthcare workers on the ground have been the subject of ongoing research.
Smaller Vaccine Vials Lead to Big Gains in Zambian Immunization rates
Lusaka, Zambia – A simple change in vaccine packaging is yielding significant results in Zambia, boosting immunization rates and reducing waste.A recent study found that switching from vials containing ten doses of the rotavirus vaccine to vials with five doses lead to a notable increase in vaccination coverage and a sharp decrease in vaccine wastage.
The study, conducted in Zambia’s Luapula and Central provinces, focused on the impact of the smaller vial size on various factors, including vaccination coverage, dropout rates, waste, session size and frequency, and healthcare worker behavior.
“While national guidelines clearly stated that a vial should be opened for each eligible child, healthcare workers often prioritized minimizing waste,” explained a researcher involved in the study. “They would typically wait for five children to arrive before opening a ten-dose vial.”
The introduction of five-dose vials significantly lowered this threshold. Healthcare workers reported being willing to open a vial for a single child, leading to a 47% reduction in wasted opened vials in clinics using the smaller format compared to those still using ten-dose vials.
Perhaps most importantly, the study revealed a remarkable increase in vaccination coverage. First-dose rotavirus vaccination rates jumped by 4.9% in the study area, while second-dose coverage increased by 3.5%.
While data on the nationwide impact of the vial change is still being collected, healthcare workers on the ground are optimistic about the long-term benefits.
“The smaller vials have made a real difference,” said one healthcare worker. “We’re seeing more children getting vaccinated, and we’re wasting less vaccine. It’s a win-win situation.”
Zambia Finds Big Gains in Immunization with Small Change: Interview with Nurse Memory Mwezi
NewsDirectory3.com – A seemingly minor tweak to zambia’s vaccine program is yielding major results in enhancing immunization rates, particularly in rural areas.
Switching from ten-dose vials of measles and rubella (MR) vaccine to smaller, five-dose vials has had a profound impact, according to healthcare workers on the ground. We spoke with Nurse Memory Mwezi, who practices at the Mwimba Health Post in Zambia’s eastern Lumezi district, to better understand this important change.
NewsDirectory3.com: Nurse Mwezi, thank you for taking the time to speak with us.
Nurse Mwezi: The pleasure is mine.
NewsDirectory3.com: Can you tell us about the challenges you faced before the introduction of the smaller MR vaccine vials?
Nurse Mwezi: It was a tough situation. We often saw only a few children needing the measles shot on certain days, perhaps two or four. But opening a ten-dose vial for such a small number meant risking wasting a large amount of precious vaccine. This led to delaying vaccinations and asking patients to return on busier days, which was not always possible for them.
NewsDirectory3.com: So,how has the transition to five-dose vials impacted your work?
Nurse Mwezi: The change has been incredible. We can now confidently vaccinate even a small group of children without worrying about wasting doses. This has made a huge difference in our daily work and our vaccination coverage rates.
NewsDirectory3.com: Have you noticed any other positive changes since the implementation of the smaller vials?
Nurse Mwezi: Absolutely! With less concern about wastage, we’ve been able to expand our community outreach efforts. Our mobile vaccination teams can now safely reach even the most remote and hard-to-reach areas within our district, ensuring that more children are protected against measles and rubella.
NewsDirectory3.com: This seems like a simple but highly effective solution. What would you say to other countries considering similar changes to their vaccine programs?
Nurse Mwezi: I would strongly encourage them to consider it. The impact on our vaccination rates and community health has been remarkable. Sometimes, seemingly small changes can make a world of difference.
NewsDirectory3.com: Thank you so much for sharing your insights, Nurse Mwezi.
Nurse Mwezi: You’re welcome. It’s critically important to spread the word about this positive change and its potential impact on global immunization efforts.