Professional Documents
Culture Documents
XX
UNICEF/Immunization/09.XX
ORIGINAL: ENGLISH
Version v2012.1
February 2012
Contents
Technical terms and acronyms...............................................................................3
1. Introduction.......................................................................................................3
1.1 Related tools...............................................................................................3
2. Organization of the VVC...................................................................................3
3. User instructions...............................................................................................3
3.1 How to start the tool....................................................................................3
3.2 How to use the data input worksheets.........................................................3
3.2.1 Vaccine_Selection worksheet..............................................................3
3.2.2 Abacus_Tables worksheet..................................................................3
3.2.2.a Storage capacity tables:.............................................................................3
3.2.2.b Using the storage capacity tables...............................................................3
3.2.2.c Analysis of transport and in-country distribution.........................................3
3.2.2.d Analysis of cold chain cost..........................................................................3
3.3 Data output sheets – results per recipient...................................................3
3.3.1 Volume_inject worksheet....................................................................3
3.3.2 Weight_inject worksheet.....................................................................3
3.3.3 Qty_waste worksheet..........................................................................3
3.3.4 Cost_supplies worksheet....................................................................3
3.4 Data output sheet – graphical illustration of results.....................................3
3.5 How to use the graphs................................................................................3
3.6 Reference data worksheets.........................................................................3
3.6.1 Passive_containers sheet:..................................................................3
3.6.2 PQEquipment sheet:...........................................................................3
3.6.3 Supplies..............................................................................................3
3.6.4 CR_FR_cost_chart..............................................................................3
3.6.5 Vaccine_database sheet:....................................................................3
3.6.6 Translation..........................................................................................3
3.6.7 Revision history...................................................................................3
Revision history........................................................................................................3
1
There is a hidden worksheet containing a database of country names.
Country: Erehwonia
Language: English
Contact: kones@who.int
Next click on the Index tag; use this worksheet to familiarize yourself with the
contents of the workbook and to navigate to the individual worksheets via the
hyperlinks provided – see Figure 2. Note that there are no hyperlinks to the graph
worksheets.
(1) This gives an example of a vaccine that is not recorded in the database.
(2) Existing vaccine in new presentation for birth dose.
(3) New vaccine added to the schedule
2
This option may be used for locally produced vaccines and for other vaccines which are not included in
the vaccine database. Alternatively, you can add the figures to the database and then use the drop-
down list.
3
Click on the - box to hide a table. Click on the + box to show it.
4
The worksheet automatically rounds up the population intervals in the 25 column headers. Depending
on the minimum and maximum figures which you entered in the data entry cells, the maximum
population in the column headings to the right of the table may exceed the maximum figure that you
entered.
Figure 7 – Using the data entry cells (similar for all charts)
STEP 4: Choose
cold chain
equipment from
drop-down list
STEP 5: Specify
equipment
utilization factor
STEP 6: Choose
schedule for Chart
Type 2
Colour coding on the chart gives an indication of viable cold chain equipment choices
for a particular target population range. Pale blue is clearly viable, pink merits a
second look and red indicates an uneconomic choice – for example large number of
ice-lined refrigerators when a cold room might be more suitable.
Characteristics of vaccines selected for use Weight of supplies National immunization schedule Supplementary
Volume data used per injection (g) (Routine vaccinations) activities (SIAs)
Injection syringe
Diluent volume
Mixing syringe
Administration
Safety boxes
Vaccine type
Presentation
Formulation
(doses/vial)
HPV added
(cm³/dose)
(cm³/dose)
campaign
schedule
Vaccine
Current
volume
H1N1
BCG freeze-dried ID 20 1.2 0.7 4.8 0.7 4.0 1.0 1.0
OPV liquid Oral 10 2.0 0.0 - 4.0 4.0
HepB liquid IM 1 18.0 0.0 4.8 3.8 1.0 1.0
DTP-HepB-Hib liquid IM 1 26.1 0.0 4.8 3.8 3.0 3.0
MMR freeze-dried SC 2 13.1 13.1 4.8 3.7 5.6 1.0 1.0
MMR freeze-dried SC 2 13.1 13.1 4.8 3.7 5.6 1.0 1.0
DT liquid IM 10 3.0 0.0 4.8 3.8 1.0 1.0
TT liquid IM 10 3.0 0.0 4.8 3.8 1.0 1.0
HPV liquid IM 1 15.0 0.0 4.8 3.8 1.0
H1N1 liquid IM 10 6.0 0.0 4.8 3.8 1.0
0 0.0 0.0 -
0 0.0 0.0 -
0 0.0 0.0 -
0 0.0 0.0 -
0 0.0 0.0 -
0 0.0 0.0 -
0 0.0 0.0 -
0 0.0 0.0 -
0 0.0 0.0 -
0 0.0 0.0 -
Total weight of dilution syringes per Unit of Population , g 0.1 Total weight
0.1 of dilution
0.0 syringes
0.0 per recipient
0.0 0.0 0.0 0.0
Total weight of injection syringes per Unit of Population , g 0.8 Total0.9 0.0 syringes
weight injection 0.0 per recipient
0.0 4.8 0.0 0.0
Total weigth of safety box per Unit of Population , g 0.7 0.8weight of0.0
Total 0.0 per recipient
safety boxes 0.0 3.8 0.0 0.0
Characteristics of vaccines selected for use Weight of supplies National immunization schedule Supplementary
Volume data used per injection (g) (Routine vaccinations) activities (SIAs)
Injection syringe
Diluent volume
Mixing syringe
Administration
New schedule
Safety boxes
Vaccine type
Presentation
Formulation
(doses/vial)
(cm³/dose)
(cm³/dose)
schedule
Measles
Vaccine
Current
volume
Characteristics of vaccines selected for use Amount of waste National immunization schedule Supplementary
Volume data used per recipient, units (Routine vaccinations) activities (SIAs)
Current schedule
Injection syringe
H1N1 campaign
Vaccine volume
Diluent volume
Mixing syringe
Administration
Vaccine type
Presentation
Formulation
(doses/vial)
HPV added
(cm³/dose)
(cm³/dose)
BCG freeze-dried ID 20 1.2 0.7 0.20 1.1 0.10 1.0 1.0
OPV liquid Oral 10 2.0 0.0 0.13 4.0 4.0
HepB liquid IM 1 18.0 0.0 1.05 1.1 1.0 1.0
DTP-HepB-Hib liquid IM 1 26.1 0.0 1.05 1.1 3.0 3.0
MMR freeze-dried SC 2 13.1 13.1 1.11 1.1 0.56 1.0 1.0
MMR freeze-dried SC 2 13.1 13.1 1.11 1.1 0.56 1.0 1.0
DT liquid IM 10 3.0 0.0 0.13 1.1 1.0 1.0
TT liquid IM 10 3.0 0.0 0.13 1.1 1.0 1.0
HPV liquid IM 1 15.0 0.0 1.05 1.1 1.0
H1N1 liquid IM 10 6.0 0.0 0.13 1.1 1.0
0 0.0 0.0
0 0.0 0.0
0 0.0 0.0
0 0.0 0.0
0 0.0 0.0
0 0.0 0.0
0 0.0 0.0
0 0.0 0.0
0 0.0 0.0
0 0.0 0.0
Nbr. of empty vials, units/ Unit of Population 0.1 Nbr.0.2 0.0 generated
of empty vials 0.0 per recipient
0.0 0.1 0.0 0.00
Nbr. of used dilution syringes generated, units/ Unit of Population 0.0 0.0 syringes
Nbr. of dilution 0.0 generated0.0 per recipient
0.0 0.0 0.0 0.00
Total nbr. of used syringes generated, units/ Unit of Population 0.2of syringes
0.2 Total nbr. 0.0 generated0.0 per recipient
0.0 1.2 0.0 0.00
Nbr. of injections, units/ Unit of Population 0.2 0.2 0.0
Nbr. of 0.0
injections per 0.0
recipient 1.1 0.0 0.00
Characteristics of vaccines selected for use Price of safe National immunization schedule Supplementary
Volume data used injection equipment (Routine vaccinations) activities (SIAs)
Diluent volume
Mixing syringe
Administration
Safety boxes
Vaccine type
Presentation
Formulation
(doses/vial)
HPV added
(cm³/dose)
(cm³/dose)
campaign
schedule
Injection
Vaccine
Current
volume
syringe
H1N1
HPV added
HPV added
Current schedule
Current schedule
0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0
Volume, cm3
Net volume of vaccines and diluents, stored at +5°C at service points, per Unit of Population
0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 16.0
Net volume of all vaccines, including OPV, stored at +5°C in lower level stores, per Unit of Volume, cm3
Population Total net storage volume of injection supplies per Unit of Population
Net volume of all vaccines except OPV stored at +5°C in higher level stores, per Unit of , cm3
Population
Cost of vaccines and safe injection equipment per recipient Estimate of the amount of injection waste generated per
recipient
Current schedule
Current schedule
Total cost of safe injection equipment per Unit of Population Total nbr. of used syringes generated, units/ Unit of Population
Total cost of vaccines per Unit of Population Nbr. of empty vials, units/ Unit of Population
Click on the SIAs_illustration tab to display the same four bar charts for SIA
activities.
Figure 15 – SIAs_illustration charts
Vaccine storage volumes Volume of diluents and safe injection equipment per
recipient
H1N1 campaign
H1N1 campaign
0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0
0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0
Total net storage volume of vaccines & diluents per recipient Total net storage volume of injection supplies per recipient
Cost of vaccines and safe injection equipment per Estimate of the amount of injection waste generated
recipient per recipient
$0.00 $0.01 $0.02 $0.03 $0.04 $0.05 $0.06 $0.07 $0.08 $0.09 $0.10 0.0 0.2 0.4 0.6 0.8 1.0 1.2 1.4
Total cost of vaccines per recipient Total cost of safe injection equipment per recipient Total nbr. of syringes generated per recipient
Nbr. of empty vials generated per recipient
12,000
Net volume of vaccines, litres
10,000
8,000
6,000
4,000
2,000
-
500,000
900,000
1,300,000
1,700,000
2,100,000
3,300,000
6,500,000
7,300,000
7,700,000
8,100,000
8,500,000
8,900,000
9,300,000
9,700,000
10,100,000
10,500,000
2,500,000
2,900,000
3,700,000
4,100,000
4,500,000
4,900,000
5,300,000
5,700,000
6,100,000
6,900,000
Total population
Current schedule @ per individual vaccine months-MaxiStock HPV added @ per individual vaccine months-MaxiStock
Legend Target
population type
5
Only OPV is now routinely stored at -20°C at national and sub-national levels. No vaccines are
routinely stored at -20°C at lower levels. Required freezer room or freezer capacity at can be estimated
using data generated by the Vaccine_Selection worksheet, multiplied by the relevant target population.
20,000
Net volume of vaccines, litres
15,000
10,000
5,000
-
2,100,000
2,500,000
3,300,000
4,500,000
5,700,000
6,100,000
6,900,000
7,300,000
8,100,000
9,300,000
9,700,000
900,000
1,300,000
1,700,000
2,900,000
3,700,000
4,100,000
4,900,000
5,300,000
6,500,000
7,700,000
8,500,000
8,900,000
10,100,000
10,500,000
500,000
Total population
Current schedule @ 4 months MaxiStock Current schedule @ 6 months MaxiStock Current schedule @ 9 months MaxiStock
In this example we see the effect of different maximum stock levels (4, 6 and 9
months) for a single chosen schedule – in this case the current schedule defined in
Vaccine_Selection.
Figure 18 shows how to read a typical graph. Here we have taken the Figure 16
example and decided that we want to establish the required net capacity of the cold
room(s) at the national vaccine store for our fictional country with a population of 9
million people. We do this by drawing a vertical line from the 9,000,000 population
figure on the x-axis and extending horizontal lines from the intersection with the two
schedule lines to the y-axis. By interpolation, this gives us a required net storage
capacity of about 8,700 litres for the current schedule and about 10,200 litres for the
new schedule with HPV added. Similar principles apply to the use of all the other
graphs.
12,000
Net volume of vaccines, litres
10,000
8,000
6,000
4,000
2,000
-
500,000
900,000
1,300,000
1,700,000
2,100,000
3,300,000
6,500,000
7,300,000
7,700,000
8,100,000
8,500,000
8,900,000
9,300,000
9,700,000
10,100,000
10,500,000
2,500,000
2,900,000
3,700,000
4,100,000
4,500,000
4,900,000
5,300,000
5,700,000
6,100,000
6,900,000
Total population
Current schedule @ per individual vaccine months-MaxiStock HPV added @ per individual vaccine months-MaxiStock
3.6.3 Supplies
This sheet includes six tables which provide lookup data on the following:
Table 1: Characteristics of safe injection equipment
Table 2: Characteristics of supplies for other child survival interventions
3.6.4 CR_FR_cost_chart
This chart plots the purchase cost of walk-in freezer rooms and cold rooms using
data provided by UNICEF Supply Division. Regression lines have been fitted to the
two datasets. The associated formulae are used by the Abacus_Tables worksheet
to establish cold chain equipment costs in the Analysis of cold chain cost table. Refer
back Figure 4, mauve box.
3.6.6 Translation
The Translation data sheet contains the data used for the available language
versions of the tool (English, French and Russian6). Follow the guidance notes if you
want to create a new language version. If you intend to do this, contact
kones@who.int for further advice, to share the translation, and to avoid duplicated
effort.
6
At the time of writing, the Russian version was incomplete.