Patrick T Wedlock1, Elizabeth A Mitgang1, Fayad Elsheikh2, Jim Leonard3, Jenn Bakal3, Joel Welling3, Jessica Crawford4, Emmanuelle Assy4, Bvudzai P Magadzire4, Ruth Bechtel4, Jay V DePasse3, Sheryl S Siegmund1, Shawn T Brown5, Bruce Y Lee6. 1. Global Obesity Prevention Center (GOPC) at Johns Hopkins University, Baltimore, MD, USA; HERMES Logistics Modeling Team, Baltimore, MD and Pittsburgh, PA, USA. 2. HERMES Logistics Modeling Team, Baltimore, MD and Pittsburgh, PA, USA. 3. HERMES Logistics Modeling Team, Baltimore, MD and Pittsburgh, PA, USA; Pittsburgh Supercomputing Center (PSC), Pittsburgh, PA, USA. 4. VillageReach, Seattle, WA, USA. 5. HERMES Logistics Modeling Team, Baltimore, MD and Pittsburgh, PA, USA; McGill Centre for Integrative Neuroscience, McGill Neurological Institute, McGill University, Montreal, Canada. 6. Global Obesity Prevention Center (GOPC) at Johns Hopkins University, Baltimore, MD, USA; HERMES Logistics Modeling Team, Baltimore, MD and Pittsburgh, PA, USA. Electronic address: brucelee@jhu.edu.
Abstract
BACKGROUND: Microneedle patch (MNP) technology is designed to simplify the process of vaccine administration; however, depending on its characteristics, MNP technology may provide additional benefits beyond the point-of-use, particularly for vaccine supply chains. METHODS: Using the HERMES modeling software, we examined replacing four routine vaccines - Measles-containing vaccine (MCV), Tetanus toxoid (TT), Rotavirus (Rota) and Pentavalent (Penta) - with MNP versions in the routine vaccine supply chains of Benin, Bihar (India), and Mozambique. RESULTS: Replacing MCV with an MNP (5 cm3-per-dose, 2-month thermostability, current single-dose price-per-dose) improved MCV availability by 13%, 1% and 6% in Benin, Bihar and Mozambique, respectively, and total vaccine availability by 1% in Benin and Mozambique, while increasing the total cost per dose administered by $0.07 in Benin, $0.56 in Bihar and $0.11 in Mozambique. Replacing TT with an MNP improved TT and total vaccine availability (3% and <1%) in Mozambique only, when the patch was 5 cm3 and 2-months thermostable but increased total cost per dose administered by $0.14. Replacing Rota with an MNP (at 5-15 cm3-per-dose, 1-2 month thermostable) improved Rota and total vaccine availability, but only improved Rota vaccine availability in Bihar (at 5 cm3, 1-2 months thermostable), while decreasing total vaccine availability by 1%. Finally, replacing Penta with an MNP (at 5 cm3, 2-months thermostable) improved Penta vaccine availability by 1-8% and total availability by <1-9%. CONCLUSIONS: An MNP for MCV, TT, Rota, or Penta would need to have a smaller or equal volume-per-dose than existing vaccine formulations and be able to be stored outside the cold chain for a continuous period of at least two months to provide additional benefits to all three supply chains under modeled conditions.
BACKGROUND: Microneedle patch (MNP) technology is designed to simplify the process of vaccine administration; however, depending on its characteristics, MNP technology may provide additional benefits beyond the point-of-use, particularly for vaccine supply chains. METHODS: Using the HERMES modeling software, we examined replacing four routine vaccines - Measles-containing vaccine (MCV), Tetanus toxoid (TT), Rotavirus (Rota) and Pentavalent (Penta) - with MNP versions in the routine vaccine supply chains of Benin, Bihar (India), and Mozambique. RESULTS: Replacing MCV with an MNP (5 cm3-per-dose, 2-month thermostability, current single-dose price-per-dose) improved MCV availability by 13%, 1% and 6% in Benin, Bihar and Mozambique, respectively, and total vaccine availability by 1% in Benin and Mozambique, while increasing the total cost per dose administered by $0.07 in Benin, $0.56 in Bihar and $0.11 in Mozambique. Replacing TT with an MNP improved TT and total vaccine availability (3% and <1%) in Mozambique only, when the patch was 5 cm3 and 2-months thermostable but increased total cost per dose administered by $0.14. Replacing Rota with an MNP (at 5-15 cm3-per-dose, 1-2 month thermostable) improved Rota and total vaccine availability, but only improved Rota vaccine availability in Bihar (at 5 cm3, 1-2 months thermostable), while decreasing total vaccine availability by 1%. Finally, replacing Penta with an MNP (at 5 cm3, 2-months thermostable) improved Penta vaccine availability by 1-8% and total availability by <1-9%. CONCLUSIONS: An MNP for MCV, TT, Rota, or Penta would need to have a smaller or equal volume-per-dose than existing vaccine formulations and be able to be stored outside the cold chain for a continuous period of at least two months to provide additional benefits to all three supply chains under modeled conditions.
Authors: Sarah N Cox; Patrick T Wedlock; Sarah W Pallas; Elizabeth A Mitgang; Tatenda T Yemeke; Sarah M Bartsch; Taiwo Abimbola; Sheryl S Sigemund; Aaron Wallace; Sachiko Ozawa; Bruce Y Lee Journal: Vaccine Date: 2021-05-25 Impact factor: 3.641