Augmenting transport versus increasing cold storage to improve vaccine supply chains.

TitleAugmenting transport versus increasing cold storage to improve vaccine supply chains.
Publication TypeJournal Article
Year of Publication2013
AuthorsHaidari LA, Connor DL, Wateska AR, Brown ST, Mueller LE, Norman BA, Schmitz MM, Paul P, Rajgopal J, Welling JS, Leonard J, Chen S-I, Lee BY
JournalPLoS One
Volume8
Issue5
Paginatione64303
Date Published2013
ISSN1932-6203
KeywordsCryopreservation, Niger, Transportation, Vaccines
Abstract

BACKGROUND: When addressing the urgent task of improving vaccine supply chains, especially to accommodate the introduction of new vaccines, there is often a heavy emphasis on stationary storage. Currently, donations to vaccine supply chains occur largely in the form of storage equipment.METHODS: This study utilized a HERMES-generated detailed, dynamic, discrete event simulation model of the Niger vaccine supply chain to compare the impacts on vaccine availability of adding stationary cold storage versus transport capacity at different levels and to determine whether adding stationary storage capacity alone would be enough to relieve potential bottlenecks when pneumococcal and rotavirus vaccines are introduced by 2015.RESULTS: Relieving regional level storage bottlenecks increased vaccine availability (by 4%) more than relieving storage bottlenecks at the district (1% increase), central (no change), and clinic (no change) levels alone. Increasing transport frequency (or capacity) yielded far greater gains (e.g., 15% increase in vaccine availability when doubling transport frequency to the district level and 18% when tripling). In fact, relieving all stationary storage constraints could only increase vaccine availability by 11%, whereas doubling the transport frequency throughout the system led to a 26% increase and tripling the frequency led to a 30% increase. Increasing transport frequency also reduced the amount of stationary storage space needed in the supply chain. The supply chain required an additional 61,269L of storage to relieve constraints with the current transport frequency, 55,255L with transport frequency doubled, and 51,791L with transport frequency tripled.CONCLUSIONS: When evaluating vaccine supply chains, it is important to understand the interplay between stationary storage and transport. The HERMES-generated dynamic simulation model showed how augmenting transport can result in greater gains than only augmenting stationary storage and can reduce stationary storage needs.

DOI10.1371/journal.pone.0064303
Alternate JournalPLoS ONE
PubMed ID23717590
PubMed Central IDPMC3661440
Grant List1U54GM088491-0109 / GM / NIGMS NIH HHS / United States
U54 GM088491 / GM / NIGMS NIH HHS / United States
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