title: Acceptability and Feasibility of Delivering Pentavalent Vaccines in a Compact, Prefilled, Autodisable Device in Vietnam and Senegal.
abstract: BACKGROUND
  Prefilled syringes are the standard in developed countries but logistic and financial barriers prevent their widespread use in developing countries. The current study evaluated use of a compact, prefilled, autodisable device (CPAD) to deliver pentavalent vaccine by field actors in Senegal and Vietnam.
  
  
  METHODS
  We conducted a logistic, programmatic, and anthropological study that included a) interviews of immunization staff at different health system levels and parents attending immunization sessions; b) observation of immunization sessions including CPAD use on oranges; and c) document review.
  
  
  RESULTS
  Respondents perceived that the CPAD would improve safety by being non-reusable and preventing needle and vaccine exposure during preparation. Preparation was considered simple and may reduce immunization time for staff and caretakers. CPAD impact on cold storage requirements depended on the current pentavalent vaccine being used; in both countries, CPAD would reduce the weight and volume of materials and safety boxes thereby potentially improving outreach strategies and waste disposal. CPAD also would reduce stock outages by bundling vaccine and syringes and reduce wastage by using a non-breakable plastic presentation. Respondents also cited potential challenges including ability to distinguish between CPAD and other pharmaceuticals delivered via a similar mechanism (such as contraceptives), safety, and concerns related to design and ease of administration (such as activation, ease of delivery, and needle diameter and length).
  
  
  CONCLUSIONS
  Compared to current pentavalent vaccine presentations in Vietnam and Senegal, CPAD technology will address some of the main barriers to vaccination, such as supply chain issues and safety concerns among health workers and families. Most of the challenges we identified can be addressed with health worker training, minor design modifications, and health messaging targeting parents and communities. Potentially the largest remaining barrier is the marginal increase in pentavalent cost--if any--from CPAD use, which we did not assess in our study.
authors.affiliation: Agence de Médecine Préventive (AMP), Ferney-Voltaire, France.
authors.forename: Elise
authors.initials: E
authors.lastname: Guillermet
authors.affiliation: Agence de Médecine Préventive (AMP), Ferney-Voltaire, France.
authors.forename: Hamadou M
authors.initials: HM
authors.lastname: Dicko
authors.affiliation: Ministry of Health, National Institute of Hygiene and Epidemiology, Hai Ba Trung, Ha Noi, Viet Nam.
authors.forename: Le Thi Phuong
authors.initials: le TP
authors.lastname: Mai
authors.affiliation: Ministry of Health, Fann Résidence, Dakar, Senegal.
authors.forename: Mamadou
authors.initials: M
authors.lastname: N'Diaye
authors.affiliation: University of Ziguinchor, Ziguinchor, Senegal.
authors.forename: Fatoumata
authors.initials: F
authors.lastname: Hane
authors.affiliation: Ministry of Health, Fann Résidence, Dakar, Senegal.
authors.forename: Seydina Ousmane
authors.initials: SO
authors.lastname: Ba
authors.affiliation: Ministry of Health, Fann Résidence, Dakar, Senegal.
authors.forename: Khadidjatou
authors.initials: K
authors.lastname: Gomis
authors.affiliation: Ministry of Health, National Institute of Hygiene and Epidemiology, Hai Ba Trung, Ha Noi, Viet Nam.
authors.forename: Nguyen Thi Thi
authors.initials: NT
authors.lastname: Tho
authors.affiliation: Ministry of Health, National Institute of Hygiene and Epidemiology, Hai Ba Trung, Ha Noi, Viet Nam.
authors.forename: Nguyen Thi Phuong
authors.initials: NT
authors.lastname: Lien
authors.affiliation: Ministry of Health, National Institute of Hygiene and Epidemiology, Hai Ba Trung, Ha Noi, Viet Nam.
authors.forename: Phan Dang
authors.initials: PD
authors.lastname: Than
authors.affiliation: Ministry of Health, National Institute of Hygiene and Epidemiology, Hai Ba Trung, Ha Noi, Viet Nam.
authors.forename: Tran Van
authors.initials: TV
authors.lastname: Dinh
authors.affiliation: Agence de Médecine Préventive (AMP), Ferney-Voltaire, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Jaillard
authors.affiliation: Agence de Médecine Préventive (AMP), Ferney-Voltaire, France.
authors.forename: Bradford D
authors.initials: BD
authors.lastname: Gessner
authors.affiliation: Agence de Médecine Préventive (AMP), Ferney-Voltaire, France.
authors.forename: Anais
authors.initials: A
authors.lastname: Colombini
mesh_terms: D017028:Caregivers; D016503:Drug Delivery Systems; D005240:Feasibility Studies; D006801:Humans; D017589:Immunization Programs; D007267:Injections; D007407:Interviews as Topic; D009934:Organization and Administration; D010342:Patient Acceptance of Health Care; D012675:Senegal; D014611:Vaccination / Q000295:instrumentation*; D014612:Vaccines / Q000008:administration & dosage*; D014744:Vietnam
chemical_list: D014612:Vaccines