Public Health Computational and Operations Research, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Vaccine. 2012 Aug 17;30(38):5637-43. doi: 10.1016/j.vaccine.2012.06.087. Epub 2012 Jul 10.
Determine the effects on the vaccine cold chain of making different types of World Health Organization (WHO) Expanded Program on Immunizations (EPI) vaccines thermostable.
Utilizing a detailed computational, discrete-event simulation model of the Niger vaccine supply chain, we simulated the impact of making different combinations of the six current EPI vaccines thermostable.
Making any EPI vaccine thermostable relieved existing supply chain bottlenecks (especially at the lowest levels), increased vaccine availability of all EPI vaccines, and decreased cold storage and transport capacity utilization. By far, the most substantial impact came from making the pentavalent vaccine thermostable, increasing its own vaccine availability from 87% to 97% and the vaccine availabilities of all other remaining non-thermostable EPI vaccines to over 93%. By contrast, making each of the other vaccines thermostable had considerably less effect on the remaining vaccines, failing to increase the vaccine availabilities of other vaccines to more than 89%. Making tetanus toxoid vaccine along with the pentavalent thermostable further increased the vaccine availability of all EPI vaccines by at least 1-2%.
Our study shows the potential benefits of making any of Niger's EPI vaccines thermostable and therefore supports further development of thermostable vaccines. Eliminating the need for refrigerators and freezers should not necessarily be the only benefit and goal of vaccine thermostability. Rather, making even a single vaccine (or some subset of the vaccines) thermostable could free up significant cold storage space for other vaccines, and thereby help alleviate supply chain bottlenecks that occur throughout the world.
确定将不同类型的世界卫生组织（世卫组织）扩大免疫规划（EPI）疫苗制成热稳定型对疫苗冷链的影响。
利用尼日尔疫苗供应链详细的计算、离散事件仿真模型，模拟了将当前六种 EPI 疫苗中的不同组合制成热稳定型的影响。
使任何 EPI 疫苗热稳定型都缓解了现有供应链的瓶颈（尤其是在最低级别），增加了所有 EPI 疫苗的可获得性，并降低了冷藏和运输能力的利用率。到目前为止，影响最大的是将五联疫苗制成热稳定型，将其自身疫苗的可获得性从 87%提高到 97%，并使所有其他非热稳定型 EPI 疫苗的疫苗可获得性提高到 93%以上。相比之下，将其他每种疫苗制成热稳定型对其他疫苗的影响要小得多，未能将其他疫苗的疫苗可获得性提高到 89%以上。与五联疫苗一起使破伤风类毒素疫苗热稳定型进一步将所有 EPI 疫苗的疫苗可获得性提高了至少 1-2%。
我们的研究表明，使尼日尔的任何 EPI 疫苗热稳定型都具有潜在的益处，因此支持进一步开发热稳定型疫苗。消除对冰箱和冰柜的需求不一定是疫苗热稳定性的唯一好处和目标。相反，即使使一种疫苗（或一些疫苗子集）热稳定型也可以为其他疫苗腾出大量冷藏空间，从而有助于缓解全球范围内出现的供应链瓶颈。
