Estivariz Concepcion F, Snider Cynthia J, Anand Abhijeet, Hampton Lee M, Bari Tajul I, Billah Mallick M, Chai Shua J, Wassilak Steven G, Heffelfinger James D, Zaman K
Global Immunization Division.
Expanded Programme on Immunization.
J Infect Dis. 2017 Jul 1;216(suppl_1):S122-S129. doi: 10.1093/infdis/jiw510.
We assessed programmatic adaptations and infants' uptake of inactivated poliovirus vaccine (IPV) after its introduction into the routine immunization schedule in Bangladesh.
Using convenience and probability sampling, we selected 23 health facilities, 36 vaccinators, and 336 caregivers, within 5 districts and 3 city corporations. We collected data during August-October 2015 by conducting interviews, reviewing vaccination records, and observing activities.
Knowledge about IPV was high among vaccinators (94%). No problems with IPV storage, transport, or waste disposal were detected, but shortages were reported in 20 health facilities (87%). Wastage per 5-dose vaccine vial was above the recommended 30% in 20 health facilities (87%); all were related to providing <5 doses per open vial. Among eligible infants, 87% and 86% received the third dose of pentavalent and oral poliovirus vaccine, respectively, but only 65% received IPV at the same visit. Among 73 infants not vaccinated with IPV, 58% of caregivers reported that vaccine was unavailable.
Bangladesh successfully introduced IPV, but shortages related to insufficient global supply and high vaccine wastage in small outreach immunization sessions might reduce its impact on population immunity. Minimizing wastage and use of a 2-dose fractional-IPV schedule could extend IPV immunization to more children.
我们评估了在孟加拉国将灭活脊髓灰质炎疫苗（IPV）纳入常规免疫规划后的项目适应性以及婴儿对该疫苗的接种情况。
我们采用便利抽样和概率抽样方法，在5个区和3个市辖区内选取了23个卫生机构、36名疫苗接种人员和336名看护人。我们于2015年8月至10月期间通过访谈、查阅疫苗接种记录以及观察活动来收集数据。
疫苗接种人员对IPV的知晓率很高（94%）。未发现IPV储存、运输或废物处理方面的问题，但有20个卫生机构（87%）报告存在短缺情况。在20个卫生机构（87%）中，每瓶5剂次的疫苗浪费率高于推荐的30%；所有浪费情况均与每瓶开封后提供的剂量不足5剂有关。在符合条件的婴儿中，分别有87%和86%的婴儿接种了第三剂五联疫苗和口服脊髓灰质炎疫苗，但只有65%的婴儿在同一次就诊时接种了IPV。在73名未接种IPV的婴儿中，58%的看护人报告称没有疫苗。
孟加拉国成功引入了IPV，但全球供应不足以及小型外展免疫接种活动中疫苗浪费率高导致的短缺情况，可能会降低其对人群免疫的影响。尽量减少浪费并采用2剂次分剂量IPV接种程序，可使更多儿童接种IPV。
