Justin R Ortiz1, Joanie Robertson2, Jui-Shan Hsu3, Stephen L Yu4, Amanda J Driscoll5, Sarah R Williams6, Wilbur H Chen7, Meagan C Fitzpatrick8, Samba Sow9, Robin J Biellik10, Kathleen M Neuzil11. 1. Center for Vaccine Development and Global Health, 685 W. Baltimore St., University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: jortiz@som.umaryland.edu. 2. PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA, USA. Electronic address: jrobertson@path.org. 3. PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA, USA. Electronic address: jhsu@path.org. 4. Center for Vaccine Development and Global Health, 685 W. Baltimore St., University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: stephen.yu@hsc.wvu.edu. 5. Center for Vaccine Development and Global Health, 685 W. Baltimore St., University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: ADriscoll@som.umaryland.edu. 6. Division of Pulmonary and Critical Care Medicine, 110 S. Paca St, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: Sarah.Williams@som.umaryland.edu. 7. Center for Vaccine Development and Global Health, 685 W. Baltimore St., University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: Wilbur.Chen@som.umaryland.edu. 8. Center for Vaccine Development and Global Health, 685 W. Baltimore St., University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: meagan.fitzpatrick@som.umaryland.edu. 9. Centre pour le Développement des Vaccins, Ministère de la Santé, BP251Bamako, Mali. Electronic address: ssow@som.umaryland.edu. 10. Independent Consultant, Tranchepied 10, 1278 La Rippe, Switzerland. Electronic address: rbiellik@gmail.com. 11. Center for Vaccine Development and Global Health, 685 W. Baltimore St., University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: kneuzil@som.umaryland.edu.
Abstract
BACKGROUND: SARS-CoV-2 vaccines will be deployed to countries with limited immunization systems. METHODS: We assessed the effect of deploying SARS-Cov-2 vaccines on cold storage capacity and immunization workload in a simulated WHO African Region country using region-specific data on immunization, population, healthcare workers (HCWs), cold storage capacity (quartile values for national and subnational levels), and characteristics of an approved SARS-CoV-2 vaccine. We calculated monthly increases in vaccine doses, doses per vaccinator, and cold storage volumes for four-month SARS-CoV-2 vaccination campaigns targeting risk groups compared to routine immunization baselines. RESULTS: Administering SARS-CoV-2 vaccines to risk groups would increase total monthly doses by 27.0% for ≥ 65 years, 91.7% for chronic diseases patients, and 1.1% for HCWs. Assuming median nurse density estimates adjusted for absenteeism and proportion providing immunization services, SARS-CoV-2 vaccination campaigns would increase total monthly doses per vaccinator by 29.3% for ≥ 65 years, 99.6% for chronic diseases patients, and 1.2% for HCWs. When we applied quartiles of actual African Region country vaccine storage capacity, routine immunization vaccine volumes exceeded national-level storage capacity for at least 75% of countries, but subnational levels had sufficient storage capacity for SARS-CoV-2 vaccines for at least 75% of countries. CONCLUSIONS: In the WHO African Region, SARS-CoV-2 vaccination campaigns would substantially increase doses per vaccinator and cold storage capacity requirements over routine immunization baselines. Pandemic vaccination campaigns would increase storage requirements of national-level stores already at their limits, but sufficient capacity exists at subnational levels. Immediate attention to strengthening immunization systems is essential to support pandemic responses.
BACKGROUND:SARS-CoV-2 vaccines will be deployed to countries with limited immunization systems. METHODS: We assessed the effect of deploying SARS-Cov-2 vaccines on cold storage capacity and immunization workload in a simulated WHO African Region country using region-specific data on immunization, population, healthcare workers (HCWs), cold storage capacity (quartile values for national and subnational levels), and characteristics of an approved SARS-CoV-2 vaccine. We calculated monthly increases in vaccine doses, doses per vaccinator, and cold storage volumes for four-month SARS-CoV-2 vaccination campaigns targeting risk groups compared to routine immunization baselines. RESULTS: Administering SARS-CoV-2 vaccines to risk groups would increase total monthly doses by 27.0% for ≥ 65 years, 91.7% for chronic diseasespatients, and 1.1% for HCWs. Assuming median nurse density estimates adjusted for absenteeism and proportion providing immunization services, SARS-CoV-2 vaccination campaigns would increase total monthly doses per vaccinator by 29.3% for ≥ 65 years, 99.6% for chronic diseasespatients, and 1.2% for HCWs. When we applied quartiles of actual African Region country vaccine storage capacity, routine immunization vaccine volumes exceeded national-level storage capacity for at least 75% of countries, but subnational levels had sufficient storage capacity for SARS-CoV-2 vaccines for at least 75% of countries. CONCLUSIONS: In the WHO African Region, SARS-CoV-2 vaccination campaigns would substantially increase doses per vaccinator and cold storage capacity requirements over routine immunization baselines. Pandemic vaccination campaigns would increase storage requirements of national-level stores already at their limits, but sufficient capacity exists at subnational levels. Immediate attention to strengthening immunization systems is essential to support pandemic responses.
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