 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
|
| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Paul K. Drain, MPH, School of Medicine, University of Washington, 3615 Phinney Ave N #B, Seattle, WA 98103, (206) 547-7648, pkdrain@u.washington.edu, Lone Simonsen, PhD, National Institute of Allergy and Infectious Disease, National Institutes of Health, 6700-B Rockledge Drive, Room 3153, Bethesda, MD 20892-7630, John Lloyd, Special Program Office, Children's Vaccine Program at PATH, 55 Avenue Voltaire, Ferney-Voltarie, F-01210, France, Robert T Chen, MD, MA, National Immunization Program, CDC, 1600 Clifton Rd, Atlanta, GA 30333, and Darin L. Zehrung, BS, Technology Solutions, Program for Appropriate Technology in Health (PATH), 1455 NW Leary Way, Seattle, WA 98107.
Since their discontinuation, multi-dose jet injectors (MDJIs) have been redesigned with several enhanced safety features suitable for conducting mass vaccination campaigns. This project compares pathogen transmission risks against current injection practices to determine if field evaluations of MDJIs should be pursued. Mathematical models were developed to estimate risks of blood-borne pathogen transmission during vaccination campaigns in developing countries. Model parameters were based on data obtained from UN agencies and various published sources. Rates of health workers infected by occupational needle-stick injuries (NSIs) were compared to rates of vaccine recipients infected by MDJIs. Among nearly 12 million nurses and doctors in developing countries, approximately 182,001 acquire a blood-borne infection from a NSI each year. NSIs sustained during mass vaccination campaigns cause 1,138 new hepatitis B infections, 133 hepatitis C infections, and 3 HIV infections each year. If new MDJIs administered 5% of the 1.2 billion annual vaccinations, then they would cause 15 hepatitis B infection each year, and one hepatitis C and HIV infection every 3.1 and 142 years, respectively. In a direct comparison, which doesn’t include unsafe injections with contaminated needles, new MDJIs cause at least 37 times fewer hepatitis B infections, 205 times fewer hepatitis C infections, and 213 times fewer HIV infections than disposable syringes. Both disposable syringes and new MDJIs pose pathogen transmission risks to vaccine recipients or health workers, but MDJIs cause significantly fewer infections than syringes. Medical researchers and health officials should pursue field evaluations of new MDJIs for use in developing-country vaccination campaigns.
Learning Objectives:
Keywords: Infectious Diseases, Health Risks
Presenting author's disclosure statement:
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.