title: The composition of demand for newly launched vaccines: results from the pneumococcal and rotavirus vaccine introductions in Ethiopia and Malawi.
abstract: Understanding post-launch demand for new vaccines can help countries maximize the benefits of immunization programmes. In particular, low- and middle-income countries (LMICs) should ensure adequate resource planning with regards to stock consumption and service delivery for new vaccines, whereas global suppliers must produce enough vaccines to meet demand. If a country underestimates the number of children seeking vaccination, a stock-out of commodities will create missed opportunities for saving lives. We describe the post-launch demand for the first dose of pneumococcal conjugate vaccine (PCV1) in Ethiopia and Malawi and the first dose of rotavirus vaccine (Rota1) in Malawi, with focus on the new birth cohort and the 'backlog cohort', comprised of older children who are still eligible for vaccination at the time of launch. PCV1 and Rota1 uptake were compared with the demand for the first dose of pentavalent vaccine (Penta1), a routine immunization that targets the same age group and immunization schedule. In the first year, the total demand for PCV1 was 37% greater than that of Penta1 in Ethiopia and 59% greater in Malawi. In the first 6 months, the demand of Rota1 was only 5.9% greater than Penta1 demand in Malawi. Over the first three post-introduction months, 70.7% of PCV1 demand in Ethiopia and 71.5% of demand in Malawi came from children in the backlog cohort, whereas only 28.0% of Rota1 demand in Malawi was from the backlog cohort. The composition of demand was impacted by time elapsed since vaccine introduction and age restrictions. Evidence suggests that countries' plans should account for the impact of backlog demand, especially in the first 3 months post-introduction. LMICs should request for higher stock volumes when compared with routine needs, plan social mobilization activities to reach the backlog cohort and allocate human resources and cold chain capacity to accommodate high demand following vaccine introduction.
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA, sscotney@clintonhealthaccess.org.
authors: B Adam
authors: BA
authors: Williams
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA.
authors: Teklay
authors: T
authors: Kidane
authors: Ministry of Health, Maternal and Child Health Division, P.O. Box 30377, Lilongwe 3 Malawi and.
authors: Geoffrey
authors: G
authors: Chirwa
authors: Ministry of Health, Maternal and Child Health Division, Lideta Subcity Addis Ababa, Ethiopia P.O. Box 1234.
authors: Neghist
authors: N
authors: Tesfaye
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA.
authors: Marta R
authors: MR
authors: Prescott
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA, sscotney@clintonhealthaccess.org.
authors: Soleine T
authors: ST
authors: Scotney
authors: Ministry of Health, Maternal and Child Health Division, P.O. Box 30377, Lilongwe 3 Malawi and.
authors: Moussa
authors: M
authors: Valle
authors: Ministry of Health, Maternal and Child Health Division, Lideta Subcity Addis Ababa, Ethiopia P.O. Box 1234.
authors: Sintayehu
authors: S
authors: Abebe
authors: Ministry of Health, Maternal and Child Health Division, P.O. Box 30377, Lilongwe 3 Malawi and.
authors: Adija
authors: A
authors: Tambuli
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA.
authors: Bridget
authors: B
authors: Malewezi
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA.
authors: Tahir
authors: T
authors: Mohammed
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA.
authors: Emily
authors: E
authors: Kobayashi
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA.
authors: Emily
authors: E
authors: Wootton
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA.
authors: Renee
authors: R
authors: Wong
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA.
authors: Rahima
authors: R
authors: Dosani
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA.
authors: Hamsa
authors: H
authors: Subramaniam
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA.
authors: Jessica
authors: J
authors: Joseph
authors: Elif
authors: E
authors: Yavuz
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA.
authors: Aliza
authors: A
authors: Apple
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA.
authors: Yann
authors: Y
authors: Le Tallec
authors: Clinton Health Access Initiative (CHAI) the global headquarters: 383 Dorchester Avenue, Suite 400, Boston, MA 02127 USA.
authors: Alice
authors: A
authors: Kang'ethe
mesh_terms: D002675:Child, Preschool; D003906:Developing Countries; D005002:Ethiopia; D006301:Health Services Needs and Demand; D006801:Humans; D017589:Immunization Programs; D007115:Immunization Schedule; D007223:Infant; D008295:Malawi; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology; D011018:Pneumonia, Pneumococcal / Q000517:prevention & control; D012401:Rotavirus / Q000276:immunology; D012400:Rotavirus Infections / Q000276:immunology / Q000517:prevention & control; D022243:Rotavirus Vaccines / Q000008:administration & dosage* / Q000276:immunology; D014611:Vaccination
chemical_list: D022242:Pneumococcal Vaccines; D022243:Rotavirus Vaccines
keywords: Decision-making; developing countries; diarrhoea; effectiveness; evidence-based policy; health care utilization; health planning; immunization; maternal and child health; policy implementation