Friday November 15. At the Kanyikopé health center, a small center located east of Lomé, a series of vaccinations, including that against measles, takes place according to the program. At 8:30 a.m., the influx is not as great as at other times. This is no surprise, according to regulars.
If everything is ready to vaccinate children accompanied by their parents, a change in the usual system has been noted: since last October, 5-dose vials have replaced those of 10 doses in this center.
“The first expected outcome is the increase in vaccination coverage of the first and second doses. Then, we seek to reduce the gap between the first and second doses, in order to reduce the dropout rate. The 5-dose vial should also reduce losses and fight more effectively against this preventable disease. »
– Eugène Aguidi, vaccinator
“We are using these new bottles, introduced by the country’s health authorities. They replaced the 10-dose ones that we used before,” explains Eugène Aguidi, one of the center’s vaccinators.
At first glance, the bottle is smaller than the old one, says the agent. It is also equipped with a vaccine monitoring tablet (VCP), a device that allows you to know if the vial has been exposed to high temperatures, based on the color of the tablet.
This vial contains the vaccine in powder form, to which the agent adds the diluent. “We use this to vaccinate 5 children. Once opened, the bottle can be used for 6 hours. After this period, it is unusable for other vaccinations,” specifies our interlocutor.
Avoiding missed vaccination opportunities
“This change results from the use of 10-dose vials. Indeed, health workers were often hesitant to open a bottle of 10 doses for just two or three children. They asked themselves: “Is it really worth opening a vial to vaccinate three children and wasting seven or even eight doses?” This led to missed opportunities. Sometimes mothers, grandparents, etc., come with only two or three children. The health worker then tells them to come back later. And sometimes, they do not come back,” explains Dr Boko Amévégbé, director of the Expanded Immunization Program (EPI) at the national level.
Credit: Naphtali Ledy
This is also what Charles Binewai, a computer scientist, says, who experienced this situation with his son. “The vaccination appointment was postponed more than twice in a health center. It was explained to me that a minimum of 10 people were needed to open the bottle. The meeting was therefore postponed three or four times. Finally, I had to look for another vaccination center,” he says. “I told myself that if a vaccination for a baby had to be postponed because there weren’t enough people, it could have consequences on my child’s health. »
“In my case, the vaccination did not take place right away. I was asked to come back another day, again because of the same problem. It was a Friday that I was finally able to vaccinate my baby, because by that time the center had scheduled enough patients. It was only then that the vaccination was carried out,” testifies Mr. Binewai.
The first expected outcome is the increase in vaccination coverage
According to the EPI director, this change will help increase the measles-rubella vaccination coverage rate in a country that experienced measles epidemics between 2022 and 2024 in almost all districts, and recorded suspected cases of measles ( approximately 1500 cases per year, affecting children from 6 months to 15 years). “From now on, if there are one or two children to be vaccinated, they must be vaccinated immediately, rather than waiting for a certain number of people to open the bottle,” he specifies.
Before changing the bottle, the agents were trained using two systems. First, district and regional executives underwent training. Then, these executives trained the vaccinators. The training covered the current epidemiology of measles and rubella, current vaccination coverage, and the benefits of this change.
“The first expected outcome is the increase in vaccination coverage of the first and second doses. Then, we seek to reduce the gap between the first and second doses, in order to reduce the dropout rate. The 5-dose vial should also reduce losses and fight more effectively against this preventable disease,” explains Eugène Aguidi, who participated in the training. He also calls for the extension of this measure to other vaccines (BCG, yellow fever, meningitis, etc.).
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