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. 2020 Aug 8;20(1):1216.
doi: 10.1186/s12889-020-09326-9.

Introduction of multi-dose PCV 13 vaccine in Benin: from the decision to vaccinators experience

Daleb Abdoulaye Alfa  1   2 , Roch A Houngnihin  3 , G Patrick Ilboudo  4 , Naomi Dick  5 , Landry Kaucley  6 , Téné-Alima Essoh  5
Affiliations

Introduction of multi-dose PCV 13 vaccine in Benin: from the decision to vaccinators experience

Daleb Abdoulaye Alfa et al. BMC Public Health. .

Abstract

Background: In 2011, Benin introduced the 13-valent pneumococcal conjugated vaccine (PCV13), in a single-dose vial, into its Expanded Programme for Immunisation (EPI) with support from Gavi. In April 2018, with the support of the Agence de Médecine Préventive Afrique (AMP) and other technical and financial partners, the single-dose vial was transitioned to a four-dose vial. Here we describe the decision-making process and the experience of the vaccinators during the change.

Methods: We carried out semi-structured, individual interviews with 61 participants individuals involved in the EPI: 7 from central level, 5 from regional level, 7 from township level and 42 from district level. The interviews were recorded and transcribed, and the information categorised, using Nvivo software, and then analysed.

Results: The Inter-agency Coordination Committee (ICC), the Benin National Advisory Committee for Vaccines and Vaccination, (BNACVV) and the World Health Organisation (WHO) (i.e., the traditional governance structures involved in vaccination decisions) were not involved in the decision to change to the four-dose vial for PCV13. The decision was taken by the EPI, supported by Gavi. The vaccination errors observed in the first months following the change in presentation were due to the absence of guidelines for changes in vaccine presentation and the central-level actors' perception that it was 'only a change in the vial', and therefore that the communication and training for a new vaccine were not required since the vaccine itself and its administration mode were unchanged.

Conclusions: It is important that the other countries eligible for Gavi support that are about to change to the multi-dose vial PCV13 presentation learn from Benin's experience. The main lessons learned are that changes in the presentation of an established vaccine should follow the same process as the introduction of a new vaccine, and that all stakeholders involved in vaccines and vaccination should participate in the decision-making process and implementation.

Keywords: Benin; Decision-making; Multi-dose vials; PCV13; Pneumococcal conjugate vaccine; Single-dose vials; Vaccinator experience.

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Conflict of interest statement

The authors declare that they do not have any competing interests.

Figures

Fig. 1
Fig. 1
The Republic of Benin and its 12 administrative departments (adapted from Mapsland, https://www.mapsland.com/africa/benin/large-detailed-administrative-divisions-map-of-benin-2007)
Fig. 2
Fig. 2
Summary of number of participants included at each level of the Benin health pyramid
See this image and copyright information in PMC

References

    1. WHO: Surveillance standards for vaccine preventable diseases, second edition [Introduction de principes de surveillance des maladies évitables par la vaccination, deuxième édition] [https://www.who.int/immunization/monitoring_surveillance/burden/vpd/stan...] (2018). Accessed 20 July 2020.
    1. WHO: Estimated Hib and pneumococcal deaths for children under 5 years of age, 2008 [https://www.who.int/immunization/monitoring_surveillance/burden/estimate...] (2013). Accessed 20 July 2020.
    1. Committee on Infectious Diseases. Recommendations for the prevention of Streptococcus pneumoniae infections in infants and children: use of 13-valent pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23). Pediatrics 2010;126(1):186–190. - PubMed
    1. Idoko OT, Mboizi RB, Okoye M, Laudat F, Ceesay B, Liang JZ, et al. Immunogenicity and safety of 13-valent pneumococcal conjugate vaccine (PCV13) formulated with 2-phenoxyethanol in multidose vials given with routine vaccination in healthy infants: an open-label randomized controlled trial. Vaccine. 2017;35(24):3256–3263. doi: 10.1016/j.vaccine.2017.04.049. - DOI - PubMed
    1. Drain PK, Nelson CM, Lloyd JS. Single-dose versus multi-dose vaccine vials for immunization programmes in developing countries. Bull World Health Organ. 2003;81:726–731. - PMC - PubMed

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