Impact of introducing the pneumococcal and rotavirus vaccines into the routine immunization program in Niger

Objectives. We investigated whether introducing the rotavirus and pneumococcal vaccines, which are greatly needed in West Africa, would overwhelm existing Schains (i.e., the series of steps required to get a vaccine from the manufacturers to the target population) in Niger. Methods. As part of the Bill and Melinda Gates Foundation-funded Vaccine Modeling Initiative, we developed a computational model to determine the impact of introducing these new vaccines to Niger's Expanded Program on Immunization vaccine Schain. Results. Introducing either the rotavirus vaccine or the 7-valent pneumococcal conjugate vaccine could overwhelm available storage and transport refrigerator space, creating bottlenecks that would prevent the flow of vaccines down to the clinics. As a result, the availability of all World Health Organization Expanded Program on Immunization vaccines to patients might decrease from an average of 69% to 28.2% (range=10%-51%). Addition of refrigerator and transport capacity could alleviate this bottleneck. Conclusions. Our results suggest that the effects on the vaccine Schain should be considered when introducing a new vaccine and that computational models can help assess evolving needs and prevent problems with vaccine delivery.