{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:58:22Z","timestamp":1790344702794,"version":"4.1.0"},"reference-count":18,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T00:00:00Z","timestamp":1586908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>The World Health Organization (WHO) recommends immunization programmes to monitor vaccine wastage at storage and service delivery points. As there were no vaccine wastage assessments in Myanmar, we aimed to assess the vaccine wastage rates in the Mandalay region. We conducted a cross-sectional descriptive study with the inclusion of all immunization sessions conducted through the twenty randomly selected subcentres in the year 2018. The wastage rates were calculated by aggregating vaccine utilization data from selected subcentres. The vaccine wastage rates for Bacillus Calmette\u2013Gu\u00e9rin (BCG) (54.9%), inactivated polio vaccine (28.3%), and measles-rubella (27.4%) were higher than the WHO indicative rates. The high vaccine wastage rates were seen in lyophilized vaccines (36.9%), vaccines requiring only a single dose per child for complete immunization (39.1%), and those with a large vial size of 20 doses (38.8%). The median session size for BCG (6), measles-rubella (4) and inactivated polio vaccine (2) were lower than their vaccine vial size of 20, 10, and 5 doses, respectively. The wastage was high due to smaller session size and larger vial size, necessitating the disposal of unused doses. Better micro-planning to increase the session size and procuring vaccines with smaller vial sizes needs to be tested as a strategy to reduce vaccine wastage.<\/jats:p>","DOI":"10.3390\/tropicalmed5020060","type":"journal-article","created":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T05:15:41Z","timestamp":1587014141000},"page":"60","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Small Session Size and Big Vial Size: Operational Research Assessing Open Vial Vaccine Wastage at the Service Delivery Points in the Mandalay Region of Myanmar During 2018"],"prefix":"10.3390","volume":"5","author":[{"given":"Aung Naing","family":"Oo","sequence":"first","affiliation":[{"name":"Expanded Programme on Immunization, Ministry of Health and Sports, Nay Pyi Taw 15011, Myanmar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pruthu","family":"Thekkur","sequence":"additional","affiliation":[{"name":"Centre for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), 75006 Paris, France"},{"name":"The Union South-East Asia Office, New Delhi 110016, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aye Mya Cha","family":"Thar","sequence":"additional","affiliation":[{"name":"Expanded Programme on Immunization, Ministry of Health and Sports, Nay Pyi Taw 15011, Myanmar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyaw Ko Ko","family":"Htet","sequence":"additional","affiliation":[{"name":"Department of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Pyin Oo Lwin 05081, Myanmar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Htar Htar","family":"Lin","sequence":"additional","affiliation":[{"name":"Expanded Programme on Immunization, Ministry of Health and Sports, Nay Pyi Taw 15011, Myanmar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,15]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2018). Immunization Coverage, World Health Organization. Available online: https:\/\/www.who.int\/en\/news-room\/fact-sheets\/detail\/immunization-coverage."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1377\/hlthaff.2015.1086","article-title":"Return On Investment From Childhood Immunization In Low- And Middle-Income Countries, 2011\u20132020","volume":"35","author":"Ozawa","year":"2016","journal-title":"Health Aff."},{"key":"ref_3","unstructured":"The Vaccine Alliance Decade of Vaccines Collaboration, Gavi. Available online: https:\/\/www.gavi.org\/our-alliance\/global-health-development\/decade-vaccine-collaboration."},{"key":"ref_4","unstructured":"World Health Organization (2017). Global Vaccine Action Plan 2011\u20132020, World Health Organization."},{"key":"ref_5","unstructured":"World Health Organization (2013). EVM Model Standard Operating Procedures Consolidated Version, with User Guide Effective Vaccine Management Initiative, World Health Organization."},{"key":"ref_6","unstructured":"World Health Organization (2017). Monitoring and Assessing Immunization Systems, World Health Organization."},{"key":"ref_7","first-page":"e119","article-title":"Vaccine wastage assessment in a primary care setting in urban India","volume":"4","author":"Chinnakali","year":"2012","journal-title":"J. Pediatric Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"6751","DOI":"10.1016\/j.vaccine.2017.09.082","article-title":"Vaccine wastage in Nigeria: An assessment of wastage rates and related vaccinator knowledge, attitudes and practices","volume":"35","author":"Wallace","year":"2017","journal-title":"Vaccine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.vaccine.2009.08.035","article-title":"Vaccine wastage in Bangladesh","volume":"28","author":"Guichard","year":"2010","journal-title":"Vaccine"},{"key":"ref_10","unstructured":"UNICEF (2010). National Rural Health Mission. Vaccine Wastage Assessment, UNICEF."},{"key":"ref_11","unstructured":"World Health Organization (2018). EPI Fact Sheet- Myanmar, World Health Organization."},{"key":"ref_12","unstructured":"Ministry of Health and Sport (2016). Expanded Program on Immunization Multi Year Plan 2017\u20132021."},{"key":"ref_13","first-page":"292","article-title":"Assessment of Vaccine Wastage in a Tertiary Care Centre of District Rohtak, Haryana","volume":"6","author":"Gupta","year":"2015","journal-title":"Natl. J. Community Med."},{"key":"ref_14","first-page":"3313","article-title":"A Cross Sectional Study of Vaccine Wastage Assessment in A Primary Health Care Setting In Rural Central India","volume":"5","author":"Patle","year":"2017","journal-title":"Sch. J. Appl. Med. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Usuf, E., Mackenzie, G., Ceesay, L., Sowe, D., Kampmann, B., and Roca, A. (2018). Vaccine wastage in The Gambia: A prospective observational study. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5762-5"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2472","DOI":"10.18203\/2320-6012.ijrms20172431","article-title":"A study to assess vaccine wastage in an immunization clinic of tertiary care centre, Gwalior, Madhya Pradesh, India","volume":"5","author":"Tiwari","year":"2017","journal-title":"Int. J. Res. Med. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"675","DOI":"10.18203\/2394-6040.ijcmph20160631","article-title":"Assessment of vaccine wastage in the immunization clinic attached to S. P. Medical College, Bikaner, Rajasthan","volume":"3","author":"Sharma","year":"2016","journal-title":"Int. J. Community Med. Public Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"7","DOI":"10.5455\/2349-3291.ijcp20150202","article-title":"Vaccine wastage assessment in a primary care setting in rural India","volume":"2","author":"Daya","year":"2015","journal-title":"Int. J. Contemp. Pediatrics"}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/5\/2\/60\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:30:50Z","timestamp":1760362250000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/5\/2\/60"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,15]]},"references-count":18,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,6]]}},"alternative-id":["tropicalmed5020060"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed5020060","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,15]]}}}