title: Vial usage, device dead space, vaccine wastage, and dose accuracy of intradermal delivery devices for inactivated poliovirus vaccine (IPV).
abstract: Intradermal delivery of a fractional dose of inactivated poliovirus vaccine (IPV) offers potential benefits compared to intramuscular (IM) delivery, including possible cost reductions and easing of IPV supply shortages. Objectives of this study were to assess intradermal delivery devices for dead space, wastage generated by the filling process, dose accuracy, and total number of doses that can be delivered per vial.
  
  
  
  Devices tested included syringes with staked (fixed) needles (autodisable syringes and syringes used with intradermal adapters), a luer-slip needle and syringe, a mini-needle syringe, a hollow microneedle device, and disposable-syringe jet injectors with their associated filling adapters. Each device was used to withdraw 0.1-mL fractional doses from single-dose IM glass vials which were then ejected into a beaker. Both vial and device were weighed before and after filling and again after expulsion of liquid to record change in volume at each stage of the process. Data were used to calculate the number of doses that could potentially be obtained from multidose vials.
  
  
  
  Results show wide variability in dead space, dose accuracy, overall wastage, and total number of doses that can be obtained per vial among intradermal delivery devices. Syringes with staked needles had relatively low dead space and low overall wastage, and could achieve a greater number of doses per vial compared to syringes with a detachable luer-slip needle. Of the disposable-syringe jet injectors tested, one was comparable to syringes with staked needles.
  
  
  
  If intradermal delivery of IPV is introduced, selection of an intradermal delivery device can have a substantial impact on vaccine wasted during administration, and thus on the required quantity of vaccine that needs to be purchased. An ideal intradermal delivery device should be not only safe, reliable, accurate, and acceptable to users and vaccine recipients, but should also have low dead space, high dose accuracy, and low overall wastage to maximize the potential number of doses that can be withdrawn and delivered.
authors.affiliation: PATH, PO Box 900922, Seattle, WA 98109, USA. Electronic address: cjarrahian@path.org.
authors.forename: Courtney
authors.initials: C
authors.lastname: Jarrahian
authors.affiliation: PATH, PO Box 900922, Seattle, WA 98109, USA.
authors.forename: Annie
authors.initials: A
authors.lastname: Rein-Weston
authors.affiliation: PATH, PO Box 900922, Seattle, WA 98109, USA.
authors.forename: Gene
authors.initials: G
authors.lastname: Saxon
authors.affiliation: PATH, PO Box 900922, Seattle, WA 98109, USA.
authors.forename: Ben
authors.initials: B
authors.lastname: Creelman
authors.affiliation: PATH, PO Box 900922, Seattle, WA 98109, USA.
authors.forename: Greg
authors.initials: G
authors.lastname: Kachmarik
authors.affiliation: Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA.
authors.forename: Abhijeet
authors.initials: A
authors.lastname: Anand
authors.affiliation: PATH, PO Box 900922, Seattle, WA 98109, USA.
authors.forename: Darin
authors.initials: D
authors.lastname: Zehrung
mesh_terms: D006801:Humans; D007271:Injections, Intradermal / Q000295:instrumentation / Q000379:methods; D009339:Needles; D011051:Poliomyelitis / Q000517:prevention & control; D017955:Poliovirus / Q000276:immunology; D011054:Poliovirus Vaccine, Inactivated / Q000008:administration & dosage*; D013594:Syringes; D014611:Vaccination / Q000295:instrumentation* / Q000379:methods*
chemical_list: D011054:Poliovirus Vaccine, Inactivated
keywords: Delivery devices; Inactivated polio vaccine; Intradermal delivery; Vaccine wastage; Vaccines