title: Impact of introducing the pneumococcal and rotavirus vaccines into the routine immunization program in Niger.
abstract: OBJECTIVE
  We investigated whether introducing the rotavirus and pneumococcal vaccines, which are greatly needed in West Africa, would overwhelm existing supply chains (i.e., the series of steps required to get a vaccine from the manufacturers to the target population) in Niger.
  
  
  METHODS
  As part of the Bill and Melinda Gates Foundation-funded Vaccine Modeling Initiative, we developed a computational model to determine the impact of introducing these new vaccines to Niger's Expanded Program on Immunization vaccine supply chain.
  
  
  RESULTS
  Introducing either the rotavirus vaccine or the 7-valent pneumococcal conjugate vaccine could overwhelm available storage and transport refrigerator space, creating bottlenecks that would prevent the flow of vaccines down to the clinics. As a result, the availability of all World Health Organization Expanded Program on Immunization vaccines to patients might decrease from an average of 69% to 28.2% (range = 10%-51%). Addition of refrigerator and transport capacity could alleviate this bottleneck.
  
  
  CONCLUSIONS
  Our results suggest that the effects on the vaccine supply chain should be considered when introducing a new vaccine and that computational models can help assess evolving needs and prevent problems with vaccine delivery.
authors.affiliation: University of Pittsburgh, Pittsburgh, PA 15213, USA. BYL1@pitt.edu
authors.forename: Bruce Y
authors.initials: BY
authors.lastname: Lee
authors.forename: Tina-Marie
authors.initials: TM
authors.lastname: Assi
authors.forename: Jayant
authors.initials: J
authors.lastname: Rajgopal
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Norman
authors.forename: Sheng-I
authors.initials: SI
authors.lastname: Chen
authors.forename: Shawn T
authors.initials: ST
authors.lastname: Brown
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Slayton
authors.forename: Souleymane
authors.initials: S
authors.lastname: Kone
authors.forename: Hailu
authors.initials: H
authors.lastname: Kenea
authors.forename: Joel S
authors.initials: JS
authors.lastname: Welling
authors.forename: Diana L
authors.initials: DL
authors.lastname: Connor
authors.forename: Angela R
authors.initials: AR
authors.lastname: Wateska
authors.forename: Anirban
authors.initials: A
authors.lastname: Jana
authors.forename: Ann E
authors.initials: AE
authors.lastname: Wiringa
authors.forename: Willem G
authors.initials: WG
authors.lastname: Van Panhuis
authors.forename: Donald S
authors.initials: DS
authors.lastname: Burke
mesh_terms: D003198:Computer Simulation; D004356:Drug Storage; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration* / Q000600:supply & distribution; D009548:Niger; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000627:therapeutic use; D012034:Refrigeration; D022243:Rotavirus Vaccines / Q000008:administration & dosage* / Q000627:therapeutic use; D014186:Transportation; D014613:Vaccines, Attenuated / Q000008:administration & dosage / Q000627:therapeutic use; D014944:World Health Organization
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines; C492457:RIX4414 vaccine; C492535:RotaTeq; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated