Lambo Kikelomo, Prescott Martha, Wiwa Owens, Adebowale Jude, Daradara Kubura
Clinton Health Access Initiative (CHAI), 7 Ganges Street Off Alvan Ikoku Way, Abuja 900271, Nigeria.
Clinton Health Access Initiative (CHAI), 383 Dorchester Ave, Suite 400, Boston, MA 02127, USA.
Vaccines (Basel). 2024 Aug 8;12(8):900. doi: 10.3390/vaccines12080900.
High vaccine wastage can serve as a critical barrier to achieving the gains of vaccination, especially in a country like Nigeria, where data on vaccine wastage are sparsely available. We determined the country-wide vaccine wastage rates and their determinants through a mixed-methods study conducted across 576 health facilities (primary and secondary) in 24 states in Nigeria. We collected facility-based immunization records from June 2018 to May 2019, in addition to healthcare workers' interviews and observations of fixed and outreach sessions. The results show that open-vial wastage ranged from 21.2% (95% CI: 20.2%, 22.2%) for the pentavalent vaccine to 72.6% (95% CI: 71.5%, 73.6%) for BCG. Open-vial wastage rates for BCG, measles, and yellow fever vaccines were higher during outreach sessions, with rates of 76.2%, 64.3%, and 65.2%, respectively. For the outreach and fixed sessions, PCV and Penta had the least wastages of 22.0% for fixed sessions and 20.4% for outreach sessions. This study identified vaccine presentation (liquid vs. lyophilized vaccines), vial size (4 dose vs. 5 dose vs. 10 dose vs. 20 dose), RI service delivery strategies (fixed vs. outreach sessions), number of children vaccinated, and human resources (healthcare workers position/cadre) as key determinants of vaccine wastages in Nigeria.
高疫苗浪费率可能成为实现疫苗接种效益的关键障碍，尤其是在像尼日利亚这样疫苗浪费数据稀缺的国家。我们通过在尼日利亚24个州的576个卫生设施（初级和二级）开展的一项混合方法研究，确定了全国范围内的疫苗浪费率及其影响因素。除了对医护人员进行访谈以及观察定点和外展接种活动外，我们还收集了2018年6月至2019年5月基于设施的免疫记录。结果显示，五价疫苗的开封瓶浪费率为21.2%（95%置信区间：20.2%，22.2%），卡介苗为72.6%（95%置信区间：71.5%，73.6%）。卡介苗、麻疹疫苗和黄热病疫苗在外展接种活动期间的开封瓶浪费率更高，分别为76.2%、64.3%和65.2%。对于外展和定点接种活动，肺炎球菌结合疫苗和五价疫苗的浪费最少，定点接种活动的浪费率为22.0%，外展接种活动的浪费率为20.4%。本研究确定疫苗剂型（液体疫苗与冻干疫苗）、瓶型大小（4剂、5剂、10剂、20剂）、免疫服务提供策略（定点接种与外展接种）、接种儿童数量以及人力资源（医护人员职位/干部身份）是尼日利亚疫苗浪费的关键决定因素。
