At least 30% of vaccine injections administered in developing countries are unsafe. Auto-Disable (single-use disposable) syringes deliver safer injections than sterilizable syringes. WHO/UNICEF/UNFPA recommend that all countries use only Auto-Disable syringes for vaccinations by 2004. Developing countries need to understand the safety and coverage benefits of introducing Auto-Disable syringes, against the economical and logistical costs, to create appropriate public health policies. Fifteen clinics in Madagascar, trained to use Auto-Disable syringes, were randomly designated to implement a (1) Auto-Disable syringe only, (2) Mixed (Auto-Disable syringes only on non-immunization days), or (3) Sterilizable syringe only program. During a five week period, data on administered vaccinations were collected, interviews with health workers were conducted, and observations were recorded. Auto-Disable syringes significantly increased the number of vaccines administered on non-immunization days [Auto-Disable only 4.4%, Mixed 5.8%, Control 1.2%]. Auto-Disable only and Mixed clinics reduced sterilization sessions by 100% and 63%, respectively. Auto-Disable syringes, estimated to be 4-6 times more expensive, increased Auto-Disable only and Mixed clinics’ annual injection costs by 412% and 119%, respectively. Auto-Disable only and Mixed programs would increase Madagascar’s national immunization budget by 3% and 1%, respectively. Auto-Disable syringes improved coverage rates by providing ready-to-use sterile syringes on non-immunization days. Auto-Disable interventions diminished the number of sterilization sessions, thereby improving injection safety. The Mixed program was the most beneficial way, with minimal costs, to phase-in Auto-Disable syringes and avoid logistical problems. Auto-Disable syringes, although more expensive, could be feasibly introduced into a developing country’s immunization program to improve vaccination coverage and safety.
Learning Objectives: Participants will learn how Auto-Disable syringes may be introduced into a developing country's national immunization program, to improve vaccination coverage rates and reduce unsafe sterilization practices, in the most economical and practical manner.
Keywords: Immunizations, Health Care Delivery
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Becton Dickinson and Company,
DestroJect GmbH Medical Devices
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.