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dc.contributor.authorAzam, JM
dc.contributor.authorSaitta, B
dc.contributor.authorBonner, K
dc.contributor.authorFerrari, MJ
dc.contributor.authorPulliam, JRC
dc.date.accessioned2021-09-14T02:23:14Z
dc.date.available2021-09-14T02:23:14Z
dc.date.issued2021-09-01
dc.identifier.pmid34481696
dc.identifier.doi10.1016/j.vaccine.2021.08.053
dc.identifier.urihttp://hdl.handle.net/10144/619987
dc.description.abstractIntroduction: Rapid outbreak response vaccination is a strategy for measles control and elimination. Measles vaccines must be stored and transported within a specified temperature range, but this can present significant challenges when targeting remote populations. Measles vaccine licensure for delivery outside cold chain (OCC) could provide more vaccine transport/storage space without ice packs, and a solution to shorten response times. However, due to vaccine safety and wastage considerations, the OCC strategy will require other operational changes, potentially including the use of 1-dose (monodose) instead of 10-dose vials, requiring larger transport/storage equipment currently achieved with 10-dose vials. These trade-offs require quantitative comparisons of vaccine delivery options to evaluate their relative benefits. Methods: We developed a modelling framework combining elements of the vaccine supply chain - cold chain, vial, team, and transport equipment types - with a measles transmission dynamics model to compare vaccine delivery options. We compared 10 strategies resulting from combinations of the vaccine supply elements and grouped into three main classes: OCC, partial cold chain (PCC), and full cold chain (FCC). For each strategy, we explored a campaign with 20 teams sequentially targeting 5 locations with 100,000 individuals each. We characterised the time needed to freeze ice packs and complete the campaign (campaign duration), vaccination coverage, and cases averted, assuming a fixed pre-deployment delay before campaign commencement. We performed sensitivity analyses of the pre-deployment delay, population sizes, and two team allocation schemes. Results: The OCC, PCC, and FCC strategies achieve campaign durations of 50, 51, and 52 days, respectively. Nine of the ten strategies can achieve a vaccination coverage of 80%, and OCC averts the most cases. Discussion: The OCC strategy, therefore, presents improved operational and epidemiological outcomes relative to current practice and the other options considered.en_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.subjectExtended controlled temperature conditions
dc.subjectMeasles
dc.subjectOutbreak response
dc.subjectOutside cold chain
dc.subjectVaccine cold chain
dc.titleModelling the relative benefits of using the measles vaccine outside cold chain for outbreak response.en_US
dc.typeArticle
dc.identifier.eissn1873-2518
dc.identifier.journalVaccineen_US
dc.source.journaltitleVaccine
refterms.dateFOA2021-09-14T02:23:15Z
dc.source.countryNetherlands


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