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      Vaccine usage and wastage in a designated Yellow Fever Vaccination Centre in North India

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          Abstract

          Purpose

          Yellow fever is a viral hemorrhagic fever transmitted through the bite of mosquitoes. World Health Organization guidelines advocate a single dose of vaccine for life-long protective immunity against yellow fever. Yellow fever vaccine is included in routine childhood immunization schedules in countries at medium or high risk of yellow fever. For some travelers, visiting endemic countries, yellow fever vaccination is recommended to protect the travelers. We calculated the yellow fever vaccine wastage rate at a designated center in North India.

          Materials and Methods

          This is a record-based study. The data for the study was obtained from the immunization center of Government Medical College, Srinagar, Jammu and Kashmir. The particulars for every vaccine recipient were present in the register. The vaccine wastage rate was calculated. The analysis was done in IBM SPSS ver. 20.0 (IBM Corp., Armonk, NY, USA) and results were presented as numbers and frequencies.

          Results

          A total of 136 doses were issued out of which 111 doses were administered from November 2017 till October 2020. The maximum number of travelers was young adults (26.1%). In 83.7% of cases, the area of the visit was Africa. The vaccine wastage rate was 18.4%.

          Conclusion

          The vaccine wastage rate was not very high and was within that recommended for vaccines in routine immunization.

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          Most cited references15

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          Global yellow fever vaccination coverage from 1970 to 2016: an adjusted retrospective analysis

          Freya Shearer, Catherine Moyes, David M. Pigott … (2017)
          Summary Background Substantial outbreaks of yellow fever in Angola and Brazil in the past 2 years, combined with global shortages in vaccine stockpiles, highlight a pressing need to assess present control strategies. The aims of this study were to estimate global yellow fever vaccination coverage from 1970 through to 2016 at high spatial resolution and to calculate the number of individuals still requiring vaccination to reach population coverage thresholds for outbreak prevention. Methods For this adjusted retrospective analysis, we compiled data from a range of sources (eg, WHO reports and health-service-provider registeries) reporting on yellow fever vaccination activities between May 1, 1939, and Oct 29, 2016. To account for uncertainty in how vaccine campaigns were targeted, we calculated three population coverage values to encompass alternative scenarios. We combined these data with demographic information and tracked vaccination coverage through time to estimate the proportion of the population who had ever received a yellow fever vaccine for each second level administrative division across countries at risk of yellow fever virus transmission from 1970 to 2016. Findings Overall, substantial increases in vaccine coverage have occurred since 1970, but notable gaps still exist in contemporary coverage within yellow fever risk zones. We estimate that between 393·7 million and 472·9 million people still require vaccination in areas at risk of yellow fever virus transmission to achieve the 80% population coverage threshold recommended by WHO; this represents between 43% and 52% of the population within yellow fever risk zones, compared with between 66% and 76% of the population who would have required vaccination in 1970. Interpretation Our results highlight important gaps in yellow fever vaccination coverage, can contribute to improved quantification of outbreak risk, and help to guide planning of future vaccination efforts and emergency stockpiling. Funding The Rhodes Trust, Bill & Melinda Gates Foundation, the Wellcome Trust, the National Library of Medicine of the National Institutes of Health, the European Union's Horizon 2020 research and innovation programme.
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            Yellow fever: epidemiology and prevention.

            Scott Barnett (2007)
            Yellow fever continues to occur in regions of Africa and South America, despite the availability of effective vaccines. Recently, some cases of severe neurologic disease and multiorgan system disease have been described in individuals who received yellow fever vaccine. These events have focused attention on the need to define criteria for judicious use of yellow fever vaccine and to describe the spectrum of adverse events that may be associated with yellow fever vaccine. Describing host factors that would increase risk of these events and identifying potential treatment modalities for yellow fever and yellow fever vaccine-associated adverse events are subjects of intense investigation.
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              Yellow fever control: current epidemiology and vaccination strategies

              Lin Chen, Mary E. Wilson (2020)
              Yellow fever (YF) outbreaks continue, have expanded into new areas and threaten large populations in South America and Africa. Predicting where epidemics might occur must take into account local mosquito populations and specific YF virus strain, as well as ecoclimatic conditions, sociopolitical and demographic factors including population size, density, and mobility, and vaccine coverage. Populations of Aedes aegypti and Aedes albopictus from different regions vary in susceptibility to and capacity to transmit YF virus. YF virus cannot be eliminated today because the virus circulates in animal reservoirs, but human disease could be eliminated with wide use of the vaccine. WHO EYE (Eliminate Yellow Fever Epidemics) is a welcome plan to control YF, with strategies to be carried out from 2017 to 2026: to expand use of YF vaccine, to prevent international spread, and to contain outbreaks rapidly. YF vaccination is the mainstay in controlling YF outbreaks, but global supply is insufficient. Therefore, dose-sparing strategies have been proposed including fractional dosing and intradermal administration. Fractional dosing has been effectively used in outbreak control but currently does not satisfy International Health Regulations; special documentation is needed for international travel. Vector control is another facet in preventing YF outbreaks, and novel methods are being considered and proposed.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Exp Vaccine Res
                Journal ID (iso-abbrev): Clin Exp Vaccine Res
                Journal ID (publisher-id): CEVR
                Title: Clinical and Experimental Vaccine Research
                Publisher: The Korean Vaccine Society
                ISSN (Print): 2287-3651
                ISSN (Electronic): 2287-366X
                Publication date (Print): September 2021
                Publication date (Electronic): 30 September 2021
                Volume: 10
                Issue: 3
                Pages: 240-244
                Affiliations
                Department of Community Medicine, Government Medical College, Srinagar, India.
                Author notes
                Corresponding author: Ruqia Quansar, MD. Department of Community Medicine, Government Medical College, Srinagar, Jammu and Kashmir-190010, India. Tel: +91-7780805735, Fax: +91-194 2503633, smsalimkhan@ 123456gmcs.edu.in
                Author information
                https://orcid.org/0000-0002-7478-1378
                https://orcid.org/0000-0002-1043-4086
                https://orcid.org/0000-0001-8559-8010
                https://orcid.org/0000-0002-1494-688X
                Article
                DOI: 10.7774/cevr.2021.10.3.240
                PMC ID: 8511585
                PubMed ID: 34703806
                SO-VID: 3750a4d7-9181-4adb-9f8e-b4fdfc600af1
                Copyright © © Korean Vaccine Society.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 05 June 2020
                Date revision received : 20 July 2021
                Date accepted : 04 September 2021
                Categories
                Subject: Original Article

                Keywords: yellow fever,vaccine,immunization
                Data availability:
                Keywords: yellow fever, vaccine, immunization

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