塞内加尔、越南和赞比亚卫生工作者对两种冻干疫苗每支容器装量的偏好和看法。
Health Care Worker Preferences and Perspectives on Doses per Container for 2 Lyophilized Vaccines in Senegal, Vietnam, and Zambia.
机构信息
JSI Research & Training Institute, Inc., Arlington, VA, USA.
Consultant, JSI Research & Training Institute, Inc., Arlington, VA, USA.
出版信息
Glob Health Sci Pract. 2020 Dec 23;8(4):680-688. doi: 10.9745/GHSP-D-20-00112.
INTRODUCTION
Limited information exists on health care workers' (HCWs) perceptions about use of multidose vaccine vials and their preferences about doses per container (DPC). We present findings from qualitative studies conducted in Senegal, Vietnam, and Zambia to explore HCWs' behavior regarding opening vials and their perceptions and preferences for the number of doses in vials of BCG and measles-containing vaccine (MCV). Zambia and Senegal currently offer MCV in 10-dose vials and BCG in 20-dose vials; 10-dose vials are used for both vaccines in Vietnam. Unused doses in vials of these reconstituted vaccines must be discarded within 6 hours.
METHODS
Key informant interviews (KIIs) were conducted with frontline HCWs in Senegal, Vietnam, and Zambia. In Senegal and Vietnam, the KIIs were conducted as part of broader formative research; in Zambia, KIIs were conducted in control districts using 10-dose MCV vials only and in intervention districts that switched from 10- to 5-dose vials during the study. During analysis, themes common to all 3 countries were synthesized. Critical themes relevant to country contexts were also examined.
RESULTS
HCWs in all 3 countries preferred containers with fewer doses for BCG and MCV to reduce wastage and increase the likelihood of vaccinating every eligible child. HCWs in Senegal and HCWs using 10-dose vials in Zambia reported sending unvaccinated children away because not enough children were present to warrant opening a new vial. In Vietnam, where sessions are typically held monthly, and in Zambia when the 5-dose vials were used, almost all HCWs reported opening a vial of MCV for even 1 child.
DISCUSSION
HCWs prefer vials with fewer DPC. Their concerns about balancing coverage and wastage influence their decisions to vaccinate every eligible child; and their perspectives are crucial to ensuring that all target populations are reached with vaccines in a timely manner.
简介
关于医护人员（HCWs）对多剂量疫苗小瓶使用的看法以及他们对每瓶剂量（DPC）的偏好，相关信息有限。我们呈现了在塞内加尔、越南和赞比亚开展的定性研究结果，以探讨 HCWs 开启小瓶的行为，以及他们对卡介苗（BCG）和含麻疹疫苗（MCV）小瓶中剂量的看法和偏好。赞比亚和塞内加尔目前提供 10 剂量小瓶的 MCV 和 20 剂量小瓶的 BCG；越南则同时使用这两种疫苗的 10 剂量小瓶。这些已重构疫苗小瓶中未使用的剂量必须在 6 小时内丢弃。
方法
在塞内加尔、越南和赞比亚对一线 HCWs 进行了关键知情人访谈（KII）。在塞内加尔和越南，这些 KII 是更广泛的形成性研究的一部分；在赞比亚，仅在使用 10 剂量 MCV 小瓶的对照地区和在研究期间从 10 剂量小瓶切换到 5 剂量小瓶的干预地区进行了 KII。在分析过程中，综合了所有 3 个国家的共同主题。还检查了与国家背景相关的关键主题。
结果
所有 3 个国家的 HCWs 都更喜欢 BCG 和 MCV 用更少剂量的容器，以减少浪费并增加为每个符合条件的儿童接种疫苗的可能性。塞内加尔的 HCWs 和赞比亚使用 10 剂量小瓶的 HCWs 报告说，由于没有足够的儿童在场，无法保证打开一个新小瓶，因此将未接种疫苗的儿童送回家。在越南，每次接种通常每月举行一次，而在使用 5 剂量小瓶时，几乎所有 HCWs 都报告说，即使只有 1 名儿童，他们也会打开 MCV 小瓶。
讨论
HCWs 更喜欢 DPC 少的小瓶。他们对平衡覆盖率和浪费的担忧影响了他们为每个符合条件的儿童接种疫苗的决定；他们的观点对于确保所有目标人群及时获得疫苗至关重要。
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