The potential effects of introducing microneedle patch vaccines into routine vaccine supply chains

AbstractBackgroundMicroneedle patch (MNP) technology is designed to simplify the process of vaccine administration; however, depending on its characteristics, MNP technology may provide additional benefits beyond the point-of-use, particularly for vaccine supply chains. MethodsUsing the HERMES model...

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Bibliographic Details
Published in:	Vaccine Vol. 37; no. 4; pp. 645 - 651
Main Authors:	Wedlock, Patrick T, Mitgang, Elizabeth A, Elsheikh, Fayad, Leonard, Jim, Bakal, Jenn, Welling, Joel, Crawford, Jessica, Assy, Emmanuelle, Magadzire, Bvudzai P, Bechtel, Ruth, DePasse, Jay V, Siegmund, Sheryl S, Brown, Shawn T, Lee, Bruce Y
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier Ltd 21-01-2019 Elsevier Limited
Subjects:	Allergy and Immunology Availability Benin Chain stores Cold storage Costs and Cost Analysis Delivery Dosage Drug Delivery Systems Formulations Health facilities Humans Immunization Programs India Influenza Vaccines - administration & dosage Influenza Vaccines - supply & distribution Logistics Measles Microinjections Microneedle patch Mozambique Population Refrigeration Rotavirus Rotavirus Vaccines - administration & dosage Rotavirus Vaccines - supply & distribution Simulation Supply chain Supply chains Tetanus Tetanus Toxoid - administration & dosage Tetanus Toxoid - supply & distribution Thermal stability Transdermal Patch Vaccination - methods Vaccines Vaccines - administration & dosage Vaccines - supply & distribution Viruses Benin Mozambique India Supply chain Delivery Microneedle patch Logistics
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Summary:	AbstractBackgroundMicroneedle patch (MNP) technology is designed to simplify the process of vaccine administration; however, depending on its characteristics, MNP technology may provide additional benefits beyond the point-of-use, particularly for vaccine supply chains. MethodsUsing the HERMES modeling software, we examined replacing four routine vaccines – Measles-containing vaccine (MCV), Tetanus toxoid (TT), Rotavirus (Rota) and Pentavalent (Penta) – with MNP versions in the routine vaccine supply chains of Benin, Bihar (India), and Mozambique. ResultsReplacing MCV with an MNP (5 cm 3-per-dose, 2-month thermostability, current single-dose price-per-dose) improved MCV availability by 13%, 1% and 6% in Benin, Bihar and Mozambique, respectively, and total vaccine availability by 1% in Benin and Mozambique, while increasing the total cost per dose administered by $0.07 in Benin, $0.56 in Bihar and $0.11 in Mozambique. Replacing TT with an MNP improved TT and total vaccine availability (3% and <1%) in Mozambique only, when the patch was 5 cm 3 and 2-months thermostable but increased total cost per dose administered by $0.14. Replacing Rota with an MNP (at 5–15 cm 3-per-dose, 1–2 month thermostable) improved Rota and total vaccine availability, but only improved Rota vaccine availability in Bihar (at 5 cm 3, 1–2 months thermostable), while decreasing total vaccine availability by 1%. Finally, replacing Penta with an MNP (at 5 cm 3, 2-months thermostable) improved Penta vaccine availability by 1–8% and total availability by <1–9%. ConclusionsAn MNP for MCV, TT, Rota, or Penta would need to have a smaller or equal volume-per-dose than existing vaccine formulations and be able to be stored outside the cold chain for a continuous period of at least two months to provide additional benefits to all three supply chains under modeled conditions.
ISSN:	0264-410X 1873-2518
DOI:	10.1016/j.vaccine.2018.12.008