WHO/IVB/09.XX
UNICEF/Immunization/09.XX
ORIGINAL: ENGLISH
User guide for the WHO
Vaccine Volume Calculator
Version v2012.1
February 2012
Contents
Technical terms and acronyms .............................................................................. 3
1.
Introduction ..................................................................................................... 5
1.1
Related tools .............................................................................................. 5
2. Organization of the VVC .................................................................................. 5
3.
User instructions ............................................................................................. 6
3.1
How to start the tool ................................................................................... 6
3.2
How to use the data input worksheets........................................................ 7
3.2.1
Vaccine_Selection worksheet............................................................. 7
3.2.2
Abacus_Tables worksheet ............................................................... 10
3.2.2.a
Storage capacity tables: ............................................................................ 10
3.2.2.b
Using the storage capacity tables ............................................................. 12
3.2.2.c
Analysis of transport and in-country distribution ....................................... 13
3.2.2.d
Analysis of cold chain cost ........................................................................ 14
3.3
Data output sheets – results per recipient ................................................ 14
3.3.1
Volume_inject worksheet ................................................................. 14
3.3.2
Weight_inject worksheet .................................................................. 15
3.3.3
Qty_waste worksheet ....................................................................... 15
3.3.4
Cost_supplies worksheet ................................................................. 16
3.4
Data output sheet – graphical illustration of results .................................. 16
3.5
How to use the graphs ............................................................................. 18
3.6
Reference data worksheets ..................................................................... 20
3.6.1
Passive_containers sheet: ............................................................... 20
3.6.2
PQEquipment sheet: ........................................................................ 20
3.6.3
Supplies ........................................................................................... 20
3.6.4
3.6.5
CR_FR_cost_chart ........................................................................... 21
Vaccine_database sheet: ................................................................. 21
3.6.6
Translation ....................................................................................... 21
3.6.7
Revision history ................................................................................ 21
Revision history .................................................................................................... 22
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Technical terms and acronyms
The following technical terms and acronyms are used in the tool:
Equipment
utilization
factor
The percentage of the net storage volume that can effectively be
used for storing vaccine. This is always less than the published net
storage volume.
FIC
Fully Immunized Child.
FOB
Free On Board (Incoterm). A standard way of expressing price
information, used in the equipment data tables.
Primary store
A store which receives some or all of its vaccine directly from a
national or international vaccine manufacturer. Example: a national
vaccine store.
MaxiStock
The maximum volume of a product or mix of products that will be
held in stock or transported based on a defined delivery frequency.
Maximum
storage
volume
The volume of vaccine or safe injection supplies for a specified
number of recipients and a specified MaxiStock.
Maxi supply
interval
The Maxi supply interval is the longest supply period that is
established for each vaccine received at primary store level. This
figure is expressed as the period in months between each vaccine
delivery.
Net storage
volume
For a freezer room, cold room, vaccine freezer, vaccine refrigerator
or cold box: the total volume inside the appliance where vaccine can
safely be stored.
Passive
container
A cold box, vaccine carrier or other device which is used to transport
vaccine at the correct temperature without use of a power source to
maintain cooling.
Pre-qualified
Vaccines or cold chain equipment which has been pre-qualified by
WHO for purchase by UN agencies.
Recipient
An individual member of the target group for a specific vaccine.
Safety stock
Safety stock level is the level established for each vaccine at primary
store level. This figure is expressed in months.
Service point
A health facility or health post where vaccine is administered.
SIA
Supplementary Immunization Activity
Sub-national
store
A store which receives vaccine from a primary store or a higher level
sub-national store and supplies one or more lower level sub-national
store and/or one or more lowest delivery level stores. For example,
a provincial store supplying one or more district stores.
Target group
Subset of the country population which is the target for receiving
each of the vaccines in the immunization schedule. This can be
expressed either in terms of the total number of Fully Immunized
Children or as a percentage of the total population.
Total
population
The total population of the country.
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Unit of
Population
(UP)
A notional single member of the population used as a basis for
calculating the average vaccine requirements of the country using
the percentage of total population method.
Wastage
factor
1/wastage rate.
Wastage rate
Expected percentage of a vaccine vial that is wasted. In this
application it includes both unopened and opened vial wastage.
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1. Introduction
The WHO Vaccine Volume Calculator (VVC) is designed to help cold chain
logisticians prepare a preliminary estimate of national cold chain equipment needs
and dry store requirements. It can be used to assess current needs based on the
existing vaccine schedule and also to forecast future needs based on up to four
alternative vaccine schedules. In addition, it provides vaccine volume data to help
with the planning of supplementary immunization activities (SIAs). Up to four
alternative SIAs can be evaluated.
The tool includes a database of WHO pre-qualified vaccines. It also includes
databases listing the range of WHO pre-qualified vaccine refrigerators and freezers
and passive containers that are likely to be encountered in the field.
1.1 Related tools
The EVM Assistant tool should be used to carry out the volume calculations required
in the course of an Effective Vaccine Management (EVM) assessment. The Vaccine
Store Sizing Tool (VSST) is designed to be used for the detailed sizing of cold rooms,
freezer rooms and dry stores as part of a site-specific equipment procurement
exercise. Both these tools use the same vaccine volume calculation methodology
and the same databases as the VVC.
2. Organization of the VVC
VVC is supplied as a ‘read-only’ Excel 2003 workbook. All worksheets are
‘protected’, but no password is used.
This section outlines the components of the VVC. The tool is an Excel workbook
divided into 29 visible colour-coded worksheets1.
The Index worksheet provides basic instructions and includes a hyperlinked index to
the individual worksheets. These worksheets are divided into three categories:
1. Data input sheets: Mandatory data entry is only required on the three worksheets
named Cover, Vaccine_Select and Abacus_Tables. Cells that require
mandatory data entry are coloured white and cells that allow optional data entry
are coloured pale yellow. All other cells are protected. Protected cells
containing formulae are generally coloured pale green, pale blue or grey.
2. Output data sheets: These make use of the input data to generate lookup
material for use by the cold chain logistician. These data are presented as four
summary tables, three sheets of bar charts and eleven graphs; how these are
used is explained below.
3. Reference data sheets: The tool uses these worksheets for lookup purposes;
they also provide the user with a ready reference guide.
In addition to the guidance on the Index worksheet the input data sheets include
step-by-step notes to guide users through the data entry process.
Worksheets tags are colour-coded by type: The index sheet tag is coloured dark
grey; data entry sheets are coloured pale yellow; output data sheets are coloured
indigo; bar charts and graphs are coloured dark green and database sheets are
coloured dark blue. Subsidiary worksheets are coloured pale grey
Sample screen shots, graphs and charts are shown in the following sections to
explain the use of the tool and how its output can be used.
1
There is a hidden worksheet containing a database of country names.
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3. User instructions
This section describes the layout and intended purpose of each of the worksheets.
3.1 How to start the tool
Open the ‘read-only’ tool and save it with the country name – for example:
VVC_Afghanistan_2011. This will allow you to save your data and avoids overwriting
the master version that you have downloaded. Click on the Cover tag. Enter the
country name, language choice and date. Currently the tool is available in English,
French and Russian; other language versions will be developed in the future.
Figure 1 – Cover worksheet
VACCINE VOLUME CALCULATOR
Country:
Erehwonia
Language:
English
Date:
11 January 2012
Click to index page
v 2012.1 - January 2012
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.
Figure 2 – Index worksheet.
Index and instructions
1) The Vaccine Volume Calculator is used to estimate the net volume of vaccines and related supplies at each level in the supply chain. It can also be used to estimate the type of cold chain
equipment needed for a specific target population. The effect of new vaccine introductions can be tested by comparing one or more of these against the current schedule.
2) How to use the tool:
STEP 1: Estimate net storage volume per recipient using the Vaccine_Selection worksheet.
STEP 2: Use the Abacus_Tables worksheet to enter the data needed to generate graphs covering the range of target populations at each supply level.
STEP 3: Use the graphs to read off the net storage volumes for a specific catchment population. Then use these data to select appropriate cold chain equipment.
Data input sheets:
Vaccine_Selection Vaccine storage volumes
Abacus_Tables Analysis of national and sub-national storage
Data output sheets: results of assessment of requirements per recipient
Volume_Inject
Weight_Inject
Qty_Waste
Cost_Supplies
Volume of diluents and safe injection equipment per recipient
Weight of safe injection equipment per recipient
Estimate of the amount of injection waste generated per recipient
Cost of vaccines and safe injection equipment per recipient
Data output sheets: graphical illustration of results
Routine_illustration Illustration of results from analysis of vaccines used in routine vaccination
SIAs_illustration Illustration of results from analysis of vaccines planned for vaccination campaign
Graphs
Abacus_NatStore_1
Abacus_NatStore_2
Abacus_Dist_1
Abacus_Dist_2
Abacus_SP_1
Abacus_SP_2
ds_Abacus_NatStore_1
ds_Abacus_NatStore_2
ds_Abacus_Dist_1
ds_Abacus_Dist_2
ds_Abacus_SP_1
ds_Abacus_SP_2
Graph for cold storage capacity at national and sub-national stores - @ +5°C: (different schedules with same Maximum Stock)
Graph for cold storage capacity at national and sub-national stores - @ +5°C: (same schedule with different Maximum Stocks)
Graph for cold storage capacity at district stores - @ +5°C: (different schedules with same Maximum Stock)
Graph for cold storage capacity at district stores - @ +5°C: (same schedule with different Maximum Stocks)
Graph for cold storage capacity at service points - @ +5°C: (different schedules with same Maximum Stock)
Graph for cold storage capacity at service points - @ +5°C: (same schedule with different Maximum Stocks)
Graph for dry storage capacity at national and sub-national stores: (different schedules with same Maximum Stock)
Graph for dry storage capacity at national and sub-national stores: (same schedule with different Maximum Stocks)
Graph for dry storage capacity at district stores: (different schedules with same Maximum Stock)
Graph for dry storage capacity at district stores: (same schedule with different Maximum Stocks)
Graph for dry storage capacity at service points (different schedules with same Maximum Stock)
Graph for dry storage capacity at service points: (same schedule with different Maximum Stocks)
Sheets with reference data:
Vaccine_database
Supplies
PQEquipment
Passive_containers
Translation
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Vaccine database
Safe injection supplies and cold chain equipment
Refrigerator and freezer database
Passive container database
Translation
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3.2 How to use the data input worksheets
The next two sections describe how to use the active worksheets to generate the
graphs. These graphs are the principal output from the tool. Provided the catchment
population for each facility is known, the logistician can use the graphs to estimate
cold chain and dry store requirements and costs on a facility by facility basis.
3.2.1 Vaccine_Selection worksheet
The first step is to collect all necessary data on the existing national immunization
schedule and any proposed new vaccine introductions. Table 1 describes the data
required; Table 2 gives an example.
Table 1 – Immunization schedule data for the net storage volume estimates
Name
Description
Vaccine type
List of all vaccines in the current immunization schedule. If the
assessment is also going to review the introduction of new vaccine(s), list
the new vaccine(s) and identify which, if any, of the existing vaccines will
be replaced.
Number of doses per vial, Uniject™, pre-filled syringe, etc.
Optional: Indicate the packed volumes as per national figures if these
exist. If left blank, the Maxi packed volume will be generated
automatically using figures from the database in the tool.
Optional: Indicate the national expected vaccine wastage rates. This will
override the WHO/GAVI indicative figure. If no national figures are
available, leave blank; the WHO/GAVI indicative figure will be generated
automatically from the database in the tool.
Expressed either as a Fully Immunized Child (FIC) or as a notional Unit
of Population (UP). UP is based on the percentage of the total population
which receives each of the vaccines in the schedule.
As set out in the national immunization schedule.
Vaccine presentation
Packed volume per
dose based on national
figure
Vaccine wastage rate
Target group
Number of doses per
recipient
Maxi supply interval
established for primary
level
Safety stock at primary
level
The Maxi supply interval is the longest supply period that is established
for each vaccine received at primary store level. This figure is expressed
as the period in months between each vaccine delivery.
Safety stock level is the level established for each vaccine at primary
store level. This figure is expressed in months.
Table 2 – Example of an immunization schedule data table
Vaccine
type
Presentation
(doses/vial or
pre-filled)
Packed
volume
per
dose/cm3
Wastage
rate (%)
Recipient
group
(% of
population)
Doses
per
target
group
Maxi
supply
interval at
primary
level in
months
Safety
stock at
primary
level in
months
Existing schedule
BCG
20
database
50
4.0
1
6
1.5
OPV
10
database
25
3.7
4
6
1.5
DTP
10
database
25
3.7
3
6
1.5
HepB
10
database
25
3.7
3
6
1.5
Measles
10
database
40
3.7
1
6
1.5
TT
10
database
25
4.2
2
6
1.5
YF
5
database
10
3.7
1
6
1.5
BCG
20
database
50
4.0
1
6
1.5
OPV
10
database
25
3.7
4
6
1.5
Measles
10
database
40
3.7
1
6
1.5
New schedule
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Vaccine
type
Presentation
(doses/vial or
pre-filled)
Packed
volume
per
dose/cm3
Wastage
rate (%)
Recipient
group
(% of
population)
Doses
per
target
group
Maxi
supply
interval at
primary
level in
months
Safety
stock at
primary
level in
months
HepB (2)
Uniject
database
5
4.0
1
6
1.5
25.0
5
3.7
3
6
1.5
DTPHepBHib (3)
Pre-filled
(1)
TT
10
database
25
4.2
2
6
1.5
YF
5
database
10
3.7
1
6
1.5
Pre-filled
database
5
3.7
1
3
0.75
Rota
(3)
(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
Click on the Vaccine_Selection worksheet. Take the immunization schedule data
you have already collected and proceed as follows. Refer also to Figure 3:
1.
Select the vaccine database filter you want to use in cell E5. You can either
choose ‘Min’, ‘Max’ or ‘Average’. The ‘Min’ choice gives you access to the
minimum packed volumes figures from the vaccine database. The second
choice ‘Max’ offers data on the maximum packed volumes figures for each
vaccine presentation. Since vaccines may be supplied to the country from
different manufacturers, the ‘max’ or ‘average’ choices are preferable.
2.
In cell E8, select the type of target group to be used for estimating vaccine
demand. There are two options: FIC, which refers to the requirement for each
Fully Immunized Child, or Unit of Population. Choosing Unit of population opens
up the cells in column L for data entry. If the FIC option is selected, column L is
blanked out. The Unit of Population option provides more flexibility, especially
where the schedule includes vaccines such as HPV whose target population
does not specifically relate to the annual birth cohort.
3.
Use the drop-down lists in the column B data entry cells to enter each of the
vaccines in the current schedule. Optionally, you may also enter any additional
vaccines that will be present in a new vaccine schedule. You will want to do this
if you are investigating the effect on storage capacity of adding or subtracting
vaccines from the existing schedule.
4.
Use the drop-down lists in column C to specify the vaccine presentations.
5.
Optionally, you can use the cells in column D and E to enter packed volume-perdose data for vaccines or diluents using actual national figures2. This will
override the maximum packed volume data from the database. If left blank, the
maximum packed volume for each vaccine will be extracted from the database.
6.
Optionally, you can enter price-per-dose figures for each vaccine in column H.
These data are used in the Routine_illustration and SIAs_illustration bar
charts to estimate vaccine cost per recipient.
7.
Optionally use the cells in column I to enter vaccine wastage rates taken from
national figures, if these exist. This will override the WHO/GAVI indicative figures
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 dropdown list.
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from the data base. If the cells in column I are left blank, the WHO/GAVI
indicative figures will automatically be used.
8.
9.
If the choice in cell E8 is Unit of Population, enter data for each vaccine in
column L. The target group for each vaccine should be expressed as the
relevant percentage of the total population – for example, 3.9%.
In column M, enter the number of doses per individual recipient for each of the
vaccines in the current schedule.
10. Optionally, in cells O16 to Q16, you can enter the name of up to four proposed
new routine immunization schedules. For each of these, enter the number of
doses per recipient for each of the vaccines in the new schedule in the
appropriate column. Note that you must repeat the column O figures for any
existing vaccines that are retained in this new schedule. Do not enter a figure if
one or more of the existing vaccines is being replaced by the new vaccine. For
example if DTP-HepB-Hib is replacing DTP and HepB, only enter doses per
recipient for the new pentavalent vaccine, not for DTP and HepB.
11. Optionally use cells S16 to U16 to name up to three alternative supplementary
immunization activities. For each of these, enter the number of doses per
recipient for each of the vaccines in the new schedule in the appropriate column.
Note: Make sure that the vaccine you want to use for the SIA is fully specified in
the manner previously described. However, you do not need to specify Maxi
supply interval or safety stock levels for SIA vaccines.
12. In column V, enter the Maxi supply interval established at primary level, in
months, for each vaccine.
13. In column W, enter the Safety stock level established at primary level, in months,
for each vaccine.
The calculated volumes per recipient for routine vaccines are accumulated in cells
M38-M41 for current immunization schedule and in cells O38-Q41 for the new
immunization schedule(s) (if any). Similarly, SIA volumes per recipient are
accumulated in cells S40-U41. These figures are used in the Abacus_Tables
worksheet to produce graphs based on one or more standardized delivery intervals.
Note that the volumes per recipient are largest when the FIC option is chosen. This is
because the calculation is based on the requirements of a single Fully Immunized
Child (0-11 months). When the Unit of Population (UP) option is selected the
calculation is based on the notional vaccine needs of an average individual member
of the population regardless of age or sex. For example, if 2% of the population are
in the 0-11 month age group, the UP will notionally receive this percentage of all the
infant vaccines. If 1% of the population are adolescent girls in the HPV target group,
the UP will notionally receive this proportion of HPV vaccine.
In the example shown in Figure 3 the UP target group type has been chosen. The
vaccines entered include BCG and HepB birth doses, OPV given at birth and 2, 3
and 4 months, DTP-HepB-Hib given at 2, 3 and 4 months, MMR given at 12 months
and 6 years, DT given at 6 years and TT give to pregnant women. A new schedule
with the addition of HPV is also added. Finally, data for an H1N1 SIA campaign are
also included. The ‘UP data’ column shows the percentage of the total population
that are planned to receive each of these vaccines.
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Figure 3 – Vaccine_select worksheet
3.2.2 Abacus_Tables worksheet
Click on the Abacus_Tables worksheet to enter the remaining data that are needed
to generate the graphs. There are five separate tables on the worksheet. These can
be shown or hidden using the grouping bar in the left hand margin3.
3.2.2.a Storage capacity tables:
The first three tables are used to estimate cold chain and dry storage requirements at
fixed storage locations as follows:

Analysis of national and sub-national storage (Figure 4).

Analysis of district level storage (Figure 5).

Analysis of service delivery level (health facility) storage (Figure 6).
Within these tables, the user is able to define alternative vaccine and dry store
maximum stock levels, select suitable cold chain equipment, define equipment
utilization factors, and specify the immunization schedules specified in
Vaccine_select is to be used for the analysis. At national, sub-national and district
levels, the user can specify different maximum stock levels for vaccines and dry
stores. At service delivery level it is assumed that vaccines and dry stores follow the
same delivery schedule.
3
Click on the - box to hide a table. Click on the + box to show it.
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Figure 4 – Analysis of national and sub-national storage
Analysis of national and sub-national storage
Analysis per
Total population (minimum)
Total population (maximum)
MaxiStock
Vaccine net volume for supply period and cold room capacities
Total population:
Estimate of cold-chain capacity per schedule (litres)
Current schedule @ per individual vaccine months-MaxiStock
HPV added @ per individual vaccine months-MaxiStock
500,000
Estimate of equipment requirements per schedule
WICR-10m3
Current schedule @ per individual vaccine months-MaxiStock: WICR-10m3
HPV added @ per individual vaccine months-MaxiStock: WICR-10m3
Estimate of cold-chain capacity per MaxiStock (litres)
Current schedule @ 4 months MaxiStock
Current schedule @ 6 months MaxiStock
Current schedule @ 9 months MaxiStock
Estimate of equipment requirements per MaxiStock
WICR-10m3
Current schedule @ 4 months MaxiStock - WICR-10m3
Current schedule @ 6 months MaxiStock - WICR-10m3
Current schedule @ 9 months MaxiStock - WICR-10m3
Estimate of net dry storage per schedule (m³)
Current schedule @ per individual vaccine months-MaxiStock
HPV added @ per individual vaccine months-MaxiStock
Estimate of net dry storage per MaxiStock (m³)
Current schedule @ 6 months MaxiStock
Current schedule @ 9 months MaxiStock
Current schedule @ 12 months MaxiStock
Current schedule @ months MaxiStock
Maximum stock levels (months)
Vaccines
Safe injection equipment
4
6
6
9
9
12
Unit of Population
500,000
10,000,000
per individual vaccine
months
380,000
400,000
900,000
Total population
1,300,000
1,700,000
444
799
1,154
470
846
1,222
Equipment utilization factor (%)
3,030
3,030
3,030
1
1
Select schedule
444
799
1,154
666
1,198
1,730
998
1,797
2,596
Equipment utilization factor (%)
3,030
3,030
3,030
1
1
1
1
1
1
2.33
2.44
3
5
7
-
4
6
4
6
Select schedule
6
9
9
14
13
18
-
Cold room cost equation
Y1 =
-2.5131
Y2 =
-3.1565
2,100,000
2,500,000
2,900,000
3,300,000
3,700,000
4,100,000
1,509
1,864
1,598
1,974
65%
3,030
3,030
1
1
1
1
Current schedule
1,509
1,864
2,263
2,795
3,394
4,193
65%
3,030
3,030
1
1
1
1
2
2
-
2,218
2,350
-
2,573
2,726
-
2,928
3,102
-
3,283
3,478
-
3,638
3,854
-
3,030
1
1
-
3,030
1
1
-
3,030
1
2
-
3,030
2
2
-
3,030
2
2
-
2,218
3,328
4,992
-
2,573
3,860
5,790
-
2,928
4,393
6,589
-
3,283
4,925
7,387
-
3,638
5,457
8,186
-
3,030
1
2
3
-
3,030
1
2
3
-
3,030
1
2
3
-
3,030
2
3
4
-
3,030
2
3
4
-
10
10
-
12
12
-
13
14
-
15
16
-
17
18
-
19
20
-
15
22
29
-
17
26
35
-
20
30
40
-
23
35
46
-
26
39
52
-
29
43
57
-
8
8
Current schedule
12
18
24
-
Figure 5 – Analysis of district level storage
Analysis of district level storage
Analysis per
Total population (minimum)
Total population (maximum)
MaxiStock
Unit of Population
100,000
300,000
3
Maximum stock levels (months)
Vaccines
Safe injection equipment
1.5
2
2
3
3
4
Vaccine net volume for supply period and cold equipment capacities (litres)
Total population
Total population:
100,000
108,000
116,000
124,000
132,000
Estimate of cold-chain capacity per schedule (litres)
Current schedule @ 3 months MaxiStock
72
77
83
89
95
HPV added @ 3 months MaxiStock
76
82
88
94
100
Estimate of equipment requirements per schedule
Equipment utilization factor (%)
80%
HBC-340
200
200
200
200
200
Current schedule @ 3 months MaxiStock - HBC-340
1
1
1
HPV added @ 3 months MaxiStock - HBC-340
1
1
1
1
Estimate of cold-chain capacity per MaxiStock (litres)
Select schedule
New schedule
New schedule @ 1.5 months MaxiStock
New schedule @ 2 months MaxiStock
New schedule @ 3 months MaxiStock
Estimate of equipment requirements per MaxiStock
Equipment utilization factor (%)
80%
BLF100AC
103
103
103
103
103
New schedule @ 1.5 months MaxiStock - BLF100AC
New schedule @ 2 months MaxiStock - BLF100AC
New schedule @ 3 months MaxiStock - BLF100AC
Estimate of net dry storage per schedule (m³)
Current schedule @ 3 months MaxiStock
0.35
0.38
0.40
0.43
0.46
HPV added @ 3 months MaxiStock
0.37
0.40
0.43
0.45
0.48
Estimate of net dry storage per MaxiStock (m³)
Select schedule
Current schedule
Current schedule @ 2 months_MaxiStock
0.23
0.25
0.27
0.29
0.31
Current schedule @ 3 months_MaxiStock
0.35
0.38
0.40
0.43
0.46
Current schedule @ 4 months_MaxiStock
0.47
0.50
0.54
0.58
0.61
-
Document1
11 of 22
140,000
148,000
156,000
164,000
172,000
180,000
100
106
-
106
112
-
112
118
-
117
124
-
123
130
-
129
136
-
200
1
1
-
200
1
1
-
200
1
1
-
200
1
1
-
200
1
1
-
200
1
1
-
-
-
-
-
-
-
103
-
103
-
103
-
103
-
103
-
103
-
0.49
0.51
-
0.52
0.54
-
0.54
0.57
-
0.57
0.60
-
0.60
0.63
-
0.63
0.66
-
0.33
0.49
0.65
-
0.34
0.52
0.69
-
0.36
0.54
0.73
-
0.38
0.57
0.76
-
0.40
0.60
0.80
-
0.42
0.63
0.84
-
20 February 2012
Figure 6 – Analysis of service delivery level storage
Analysis of service delivery level storage
Analysis per
Total population (minimum)
Total population (maximum)
MaxiStock
Unit of Population
1,000
40,000
2
Maximum stock levels (months)
Vaccines
Safe injection equipment
1
2
1.5
3
2
4
Vaccine net volume for supply period and cold equipment capacities (litres)
Total population
Total population:
1,000
3,000
5,000
7,000
9,000
Estimate of cold-chain capacity per schedule (litres)
Current schedule @ 2 months MaxiStock
1
2
3
4
5
HPV added @ 2 months MaxiStock
1
2
3
4
5
Estimate of equipment requirements per schedule
Equipment utilization factor (%)
80%
MK 074
20
20
20
20
20
Current schedule @ 2 months MaxiStock - MK 074
HPV added @ 2 months MaxiStock - MK 074
Estimate of cold-chain capacity per MaxiStock (litres)
Select schedule
Current schedule
New schedule @ 1 months MaxiStock
0
1
1
2
3
New schedule @ 1.5 months MaxiStock
0
1
2
3
4
New schedule @ 2 months MaxiStock
1
2
3
4
5
Estimate of equipment requirements per MaxiStock
Equipment utilization factor (%)
80%
MKS044
20
20
20
20
20
New schedule @ 1 months MaxiStock - MKS044
New schedule @ 1.5 months MaxiStock - MKS044
New schedule @ 2 months MaxiStock - MKS044
Estimate of net dry storage per schedule (m³)
Current schedule @ 2 months MaxiStock
0.00
0.01
0.01
0.02
0.02
HPV added @ 2 months MaxiStock
0.00
0.01
0.01
0.02
0.02
Estimate of net dry storage per MaxiStock (m³)
Select schedule
New schedule
New schedule @ 2 months MaxiStock
0.01
0.01
0.02
0.02
New schedule @ 3 months MaxiStock
0.00
0.01
0.02
0.02
0.03
New schedule @ 4 months MaxiStock
0.00
0.01
0.02
0.03
0.04
-
11,000
13,000
15,000
17,000
19,000
21,000
6
7
-
7
8
-
9
9
-
10
10
-
11
11
-
12
13
-
20
-
20
-
20
1
1
-
20
1
1
-
20
1
1
-
20
1
1
-
3
5
6
-
4
6
7
-
4
6
9
-
5
7
10
-
5
8
11
-
6
9
12
-
20
-
20
-
20
1
-
20
1
-
20
1
1
-
20
1
1
-
0.03
0.03
-
0.03
0.03
-
0.03
0.04
-
0.04
0.04
-
0.04
0.05
-
0.05
0.05
-
0.03
0.04
0.05
-
0.03
0.05
0.06
-
0.03
0.05
0.07
-
0.04
0.06
0.08
-
0.04
0.07
0.09
-
0.05
0.07
0.10
-
3.2.2.b Using the storage capacity tables
Figure 7 shows the procedure for completing the data entry cells; these are common
across all the storage capacity tables and similar in the transport at cost tables (see
below).

STEP 1: The first step in all these tables is to specify a minimum and maximum
target population size for the table and associated graphs based on the number
of fully immunized children or the total population as appropriate. For example, in
the first table, if the smallest sub-national store serves a total population of
600,000 and the total population of the country is 9,000,000, choose minimum
and maximum figures that cover this range – say 500,000 to 10,000,000. This
will enable data for all the national and sub-national stores in the country to be
read off the relevant graphs4.

STEP 2: Choose a MaxiStock option to generate a Type 1 chart (see below).
Choosing the ‘per individual vaccine’ option in the header tables of the national
and sub-national storage table generates storage capacity data based on the
supply interval and safety stock data you have entered in columns V and W of the
Vaccine_Selection worksheet. These data are only relevant at national
(primary) store level where individual vaccines in the schedule may be received
from the vaccine supplier at different intervals. In the example shown in Figure 3,
most vaccines are on a 4 month supply interval, DTP-HepB-Hib and HPV are
supplied 3-monthly and H1N1 is supplied once a year as a campaign vaccine.
When calculating maximum stock levels (MaxiStock), the ‘per individual vaccine’
data in the table and on the associated graphs takes account of these variable
supply intervals.

STEP 3: Choose MaxiStock options to generate a Type 2 chart (see below). The
data entry table allows you to enter up to four separate MaxiStock levels for both
vaccines and safe injection supplies.

STEP 4: Choose appropriate cold chain equipment from the drop down
equipment lists.
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.
Document1
12 of 22
20 February 2012

STEP 5: Enter an appropriate utilization factor for the cold chain equipment.

STEP 6: Choose the immunization schedule you want to use to generate the
Type 2 graph.
Figure 7 – Using the data entry cells (similar for all charts)
Target group type
from
Vaccine_Selection
STEP 2: Select
MaxiStock option
for Chart Type 1
STEP 1: Enter min
and max
population
STEP 3: Select
MaxiStock options
for Chart Type 2
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.
3.2.2.c Analysis of transport and in-country distribution
The fourth table in the series covers analysis of transport and in-country distribution.
The user specifies the type of cold box used for vaccine distribution. Currently there
is no option covering the use of refrigerated vehicles. Figure 8 shows an example.
There is no graph associated with this table.
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20 February 2012
Figure 8 - Analysis of transport and in-country distribution
Analysis of transport and in-country distribution
Analysis per
Total population (minimum)
Total population (maximum)
shipments per year
shipments per year
Vaccines
Safe injection equipment
4
4
6
6
12
12
Unit of Population
1,000
20,000
6
Transport estimate per delivery
Total population:
Total volume of vaccines per delivery (litres)
Current schedule @ 6 shipments per year
HPV added @ 6 shipments per year
Estimate of number of passive containers required
CB_large
Current schedule @ 6 shipments per year - CB_large
HPV added @ 6 shipments per year - CB_large
Total volume of safe injection equipment per delivery (m³)
Current schedule @ 6 shipments per year
HPV added @ 6 shipments per year
Total volume of vaccines per delivery (litres)
Current schedule @ 4 shipments per year
Current schedule @ 6 shipments per year
Current schedule @ 12 shipments per year
Estimate of number of passive containers required
CB_large
Current schedule @ 4 shipments per year - CB_large
Current schedule @ 6 shipments per year - CB_large
Current schedule @ 12 shipments per year - CB_large
Total volume of safe injection equipment per delivery (m³)
Current schedule @ 4 shipments per year
Current schedule @ 6 shipments per year
Current schedule @ 12 shipments per year
Total population
2,600
3,400
1,000
1,800
4,200
5,000
5,800
6,600
7,400
8,200
9,000
0
1
-
1
1
-
1
1
-
2
2
-
2
2
-
2
3
-
3
3
-
3
3
-
4
4
-
4
4
-
4
5
-
20.00
-
20.00
-
20.00
-
20.00
-
20.00
-
20.00
-
20.00
-
20.00
-
20.00
-
20.00
-
20.00
-
0.01
0.01
0.01
0.01
Current schedule
2
3
2
2
1
1
-
0.01
0.01
-
0.01
0.01
-
0.02
0.02
-
0.02
0.02
-
0.02
0.02
-
0.02
0.02
-
4
2
1
-
4
3
1
-
5
3
2
-
5
4
2
-
6
4
2
-
6
4
2
-
0.00
0.00
1
0
0
-
0.00
0.01
0.00
0.01
Select schedule
1
2
1
1
0
1
-
20.00
-
20.00
-
20.00
-
20.00
-
20.00
-
20.00
-
20.00
-
20.00
-
20.00
-
20.00
-
20.00
-
0.00
0.00
-
0.01
0.00
-
0.01
0.01
-
0.01
0.01
-
0.01
0.01
-
0.02
0.01
-
0.02
0.01
-
0.02
0.02
-
0.03
0.02
-
0.03
0.02
-
0.03
0.02
-
3.2.2.d Analysis of cold chain cost
The final table covers analysis of cold chain cost. There are no data entry options for
this table. Figure 9 shows and example. Figure 8 shows an example. There is no
graph associated with this table.
Figure 9 – Analysis of cold chain cost
Analysis of cold chain cost
Analysis per
Total population (minimum)
Total population (maximum)
MaxiStock
Total population:
Total estimated cold-chain purchase cost, $
Current schedule @ per individual vaccine months-MaxiStock
HPV added @ per individual vaccine months-MaxiStock
Estimated purchase cost of litre net capacity of cold chain ($/litre)
Current schedule @ per individual vaccine months-MaxiStock
HPV added @ per individual vaccine months-MaxiStock
Total estimated cold-chain purchase cost, $
Current schedule @ 4 months MaxiStock
Current schedule @ 6 months MaxiStock
Current schedule @ 9 months MaxiStock
Estimated purchase cost of litre net capacity of cold chain ($/litre)
Current schedule @ 4 months MaxiStock
Current schedule @ 6 months MaxiStock
Current schedule @ 9 months MaxiStock
3.3
Unit of Population
500,000
10,000,000
per individual vaccine
Maximum stock levels (months)
4
6
9
0
Total population
1,300,000
1,700,000
2,100,000
2,500,000
500,000
900,000
2,900,000
3,300,000
3,700,000
4,100,000
4,500,000
$3,621.09
$4,207.57
$0.00
$0.00
$0.00
$6,504.96
$7,556.06
$0.00
$0.00
$0.00
$9,377.28
$10,888.93
$0.00
$0.00
$0.00
$12,238.03
$14,206.18
$0.00
$0.00
$0.00
$15,087.23
$17,507.81
$0.00
$0.00
$0.00
$17,924.87
$20,793.83
$0.00
$0.00
$0.00
$20,750.95
$24,064.23
$0.00
$0.00
$0.00
$23,565.48
$27,319.01
$0.00
$0.00
$0.00
$26,368.45
$30,558.17
$0.00
$0.00
$0.00
$29,159.85
$33,781.72
$0.00
$0.00
$0.00
$31,939.70
$36,989.64
$0.00
$0.00
$0.00
$7.45
$7.45
$7.44
$7.43
$7.42
$7.41
$7.41
$7.40
$7.39
$7.38
$7.38
$7.36
$7.36
$7.34
$7.35
$7.33
$7.33
$7.31
$7.32
$7.29
$7.30
$7.27
$3,306.37
$4,953.91
$7,418.16
$0.00
$5,940.62
$8,892.65
$13,297.83
$0.00
$8,565.25
$12,809.72
$19,128.74
$0.00
$11,180.24
$16,705.12
$24,910.89
$0.00
$13,785.60
$20,578.85
$30,644.28
$0.00
$16,381.33
$24,430.91
$36,328.90
$0.00
$18,967.43
$28,261.29
$41,964.76
$0.00
$21,543.90
$32,070.00
$47,551.86
$0.00
$24,110.73
$35,857.04
$53,090.20
$0.00
$26,667.93
$39,622.41
$58,579.78
$0.00
$29,215.50
$43,366.11
$64,020.60
$0.00
$7.45
$7.44
$7.43
#DIV/0!
$7.44
$7.42
$7.40
#DIV/0!
$7.42
$7.40
$7.37
#DIV/0!
$7.41
$7.38
$7.34
#DIV/0!
$7.40
$7.36
$7.31
#DIV/0!
$7.38
$7.34
$7.28
#DIV/0!
$7.37
$7.32
$7.25
#DIV/0!
$7.36
$7.30
$7.22
#DIV/0!
$7.34
$7.28
$7.19
#DIV/0!
$7.33
$7.26
$7.16
#DIV/0!
$7.32
$7.24
$7.13
#DIV/0!
Data output sheets – results per recipient
3.3.1 Volume_inject worksheet
Clicking on Volume_inject to will show the volume of diluents and injection
equipment per recipient which are required for the schedule(s) specified on the
Vaccine_Selection worksheet. The worksheet uses default values for the AD syringe
reconstitution syringe and safety box unit volumes. You can over-ride any one of
these figures by entering a value in the relevant pale yellow cell.
Document1
14 of 22
20 February 2012
Figure 10 – Volume_inject worksheet
Weight of safe injection equipment per recipient
Optional data entry only
4.4 gram
6.6 gram
376.5 gram
BCG
OPV
HepB
DTP-HepB-Hib
MMR
MMR
DT
TT
HPV
H1N1
freeze-dried
liquid
liquid
liquid
freeze-dried
freeze-dried
liquid
liquid
liquid
liquid
ID
Oral
IM
IM
SC
SC
IM
IM
IM
IM
20
10
1
1
2
2
10
10
1
10
0
0
0
0
0
0
0
0
0
0
1.2
2.0
18.0
26.1
13.1
13.1
3.0
3.0
15.0
6.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.7
0.0
0.0
0.0
13.1
13.1
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
4.8
4.8
4.8
4.8
4.8
4.8
4.8
4.8
0.7
3.7
3.7
Current
schedule
Safety boxes
Mixing syringe
4.8
National immunization schedule
(Routine vaccinations)
4.0
3.8
3.8
5.6
5.6
3.8
3.8
3.8
3.8
-
Supplementary
activities (SIAs)
1.0
4.0
1.0
3.0
1.0
1.0
1.0
1.0
H1N1
campaign
Weight of supplies
per injection (g)
Injection syringe
Diluent volume
(cm³/dose)
Vaccine
volume
(cm³/dose)
Presentation
(doses/vial)
Administration
Formulation
Vaccine type
Characteristics of vaccines selected for use
Volume data used
HPV added
OPTION: Over-ride weight of AD syringe, g/unit:
OPTION: Over-ride weight of reconstitution syringe, g/unit:
OPTION: Over-ride weight of safety box, g/unit:
Index
1.0
4.0
1.0
3.0
1.0
1.0
1.0
1.0
1.0
1.0
Total weight of dilution syringes per Unit of Population , g
Total weight of injection syringes per Unit of Population , g
Total weigth of safety box per Unit of Population , g
0.1 Total weight
0.1 of dilution
0.0 syringes
0.0 per recipient
0.0
0.8 Total 0.9
weight injection
0.0 syringes
0.0 per recipient
0.0
0.7
Total
0.8weight of0.0
safety boxes
0.0 per recipient
0.0
0.0
4.8
3.8
0.0
0.0
0.0
0.0
0.0
0.0
Total weight of injection supplies per Unit of Population
Increase of total weight compared to current schedule
1.7Total weight
1.8 of injection
0.0 supplies
0.0 per recipient
0.0
5%
8.6
0.0
0.0
3.3.2 Weight_inject worksheet
Click on the Weight_inject tab and you will see a table showing the weight of
injection equipment and safety boxes per recipient relating to the schedule(s)
specified on the Vaccine_Selection worksheet. The worksheet uses default values
for the AD syringe reconstitution syringe and safety box unit weights. You can override any one of these figures by entering a value in the relevant pale yellow cell.
Figure 11 – Weight_inject worksheet
Weight of safe injection equipment per recipient
Optional data entry only
4.4 gram
6.6 gram
376.5 gram
BCG
OPV
DTP-HepB-Hib
Measles
Rota_liq
Measles
freeze-dried
liquid
liquid
freeze-dried
liquid
freeze-dried
ID
Oral
IM
SC
Oral
SC
20
10
1
1
1
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5.0
2.0
5.0
26.1
17.1
3.5
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
1.6
0.0
4.0
26.1
0.0
4.0
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
4.6
0.7
4.6
4.6
7.0
4.6
0.7
4.0
3.8
7.5
4.1
-
1.0
4.0
3.0
1.0
Supplementary
activities (SIAs)
Measles
Current
schedule
Safety boxes
National immunization schedule
(Routine vaccinations)
New schedule
Weight of supplies
per injection (g)
Mixing syringe
Diluent volume
(cm³/dose)
Vaccine
volume
(cm³/dose)
Presentation
(doses/vial)
Administration
Formulation
Vaccine type
Characteristics of vaccines selected for use
Volume data used
Injection syringe
OPTION: Over-ride weight of AD syringe, g/unit:
OPTION: Over-ride weight of reconstitution syringe, g/unit:
OPTION: Over-ride weight of safety box, g/unit:
Index
1.0
4.0
3.0
1.0
1.0
1.0
Total weight of dilution syringes per Target Group, g
Total weight of injection syringes per Target Group, g
Total weigth of safety box per Target Group, g
0.3 Total weight
0.3 of dilution
0.0 syringes
0.0 per recipient
0.0
0.9 Total 0.9
weight injection
0.0 syringes
0.0 per recipient
0.0
0.9
Total
0.9weight of0.0
safety boxes
0.0 per recipient
0.0
0.7
4.6
4.1
0.0
0.0
0.0
0.0
0.0
0.0
Total weight of injection supplies per Target Group
Increase of total weight compared to current schedule
2.1Total weight
2.1 of injection
0.0 supplies
0.0 per recipient
0.0
0%
9.4
0.0
0.0
3.3.3 Qty_waste worksheet
Click on the Qty_waste tab to show a table containing an estimate of the volume of
empty vials and used syringes generated per recipient, for each of the chosen
schedules. There are no over-ride options on this worksheet.
Document1
15 of 22
20 February 2012
Figure 12 – Qty_waste worksheet
Estimate of the amount of injection waste generated per recipient
BCG
OPV
HepB
DTP-HepB-Hib
MMR
MMR
DT
TT
HPV
H1N1
freeze-dried
liquid
liquid
liquid
freeze-dried
freeze-dried
liquid
liquid
liquid
liquid
ID
Oral
IM
IM
SC
SC
IM
IM
IM
IM
1.2
2.0
18.0
26.1
13.1
13.1
3.0
3.0
15.0
6.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
20
10
1
1
2
2
10
10
1
10
0
0
0
0
0
0
0
0
0
0
0.7
0.0
0.0
0.0
13.1
13.1
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
0.20
0.13
1.05
1.05
1.11
1.11
0.13
0.13
1.05
0.13
1.1
1.1
1.1
1.1
1.1
1.1
1.1
1.1
1.1
1.0
4.0
1.0
3.0
1.0
1.0
1.0
1.0
0.10
0.56
0.56
H1N1 campaign
Supplementary
activities (SIAs)
HPV added
Current schedule
National immunization schedule
(Routine vaccinations)
Mixing syringe
Injection syringe
No. of empty vials
Amount of waste
per recipient, units
Diluent volume
(cm³/dose)
Vaccine volume
(cm³/dose)
Presentation
(doses/vial)
Administration
Formulation
Vaccine type
Characteristics of vaccines selected for use
Volume data used
Index
1.0
4.0
1.0
3.0
1.0
1.0
1.0
1.0
1.0
1.0
Nbr. of empty vials, units/ Unit of Population
Nbr. of used dilution syringes generated, units/ Unit of Population
Total nbr. of used syringes generated, units/ Unit of Population
Nbr. of injections, units/ Unit of Population
0.1 Nbr.0.2
of empty vials
0.0 generated
0.0 per recipient
0.0
0.0
Nbr. of dilution
0.0 syringes
0.0 generated
0.0 per recipient
0.0
0.2 Total nbr.
0.2of syringes
0.0 generated
0.0 per recipient
0.0
0.2
0.2
Nbr.
0.0
of injections
0.0 per recipient
0.0
Increase in nbr.of vials compared to current schedule
Increase in nbr. of syringes compared to current schedule
Increase in nbr. of injections compared to current schedule
0.1
0.0
1.2
1.1
0.0
0.0
0.0
0.0
0.00
0.00
0.00
0.00
8%
5%
6%
3.3.4 Cost_supplies worksheet
The Cost_supplies worksheet is the final one in this sequence. It sets out the cost
of the vaccines, injection equipment and safety boxes for each of the chosen
schedules. An over-ride option is available for syringe and safety box unit costs.
Figure 13 – Cost_supplies worksheet
Cost of vaccines and safe injection equipment per recipient
Optional data entry only
$0.07
$0.06
$1.03
BCG
OPV
HepB
DTP-HepB-Hib
MMR
MMR
DT
TT
HPV
H1N1
freeze-dried
liquid
liquid
liquid
freeze-dried
freeze-dried
liquid
liquid
liquid
liquid
ID
Oral
IM
IM
SC
SC
IM
IM
IM
IM
20
10
1
1
2
2
10
10
1
10
0
0
0
0
0
0
0
0
0
0
1.2
2.0
18.0
26.1
13.1
13.1
3.0
3.0
15.0
6.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.7
0.0
0.0
0.0
13.1
13.1
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
$0.08
$0.08
$0.08
$0.08
$0.08
$0.08
$0.08
$0.08
$0.08
$0.01
$0.03
$0.03
$0.01
$0.00
$0.01
$0.01
$0.02
$0.02
$0.01
$0.01
$0.01
$0.01
1.0
4.0
1.0
3.0
1.0
1.0
1.0
1.0
Supplementary
activities (SIAs)
H1N1
campaign
HPV added
National immunization schedule
(Routine vaccinations)
Safety boxes
Mixing syringe
Price of safe
injection equipment
Injection
syringe
Diluent volume
(cm³/dose)
Vaccine
volume
(cm³/dose)
Presentation
(doses/vial)
Administration
Formulation
Vaccine type
Characteristics of vaccines selected for use
Volume data used
Current
schedule
OPTION: Over-ride price of AD syringe, $/unit:
OPTION: Over-ride price of reconstitution syringe, $/unit:
OPTION: Over-ride price of safety box, $/unit:
Index
1.0
4.0
1.0
3.0
1.0
1.0
1.0
1.0
1.0
1.0
Total cost of vaccines per Unit of Population
$0.00
$0.00
Total cost
$0.00
of vaccines
$0.00per recipient
$0.00
Total cost of safe injection equipment per Unit of Population
Total cost
$0.02
of safe
$0.02
injection
$0.00
equipment
$0.00per recipient
$0.00
$0.00
$0.09
$0.00
$0.00
$0.00
$0.00
Total cost of vaccines & safe injection equipment per Unit of
Total
Population
cost of vaccines
$0.02& safe
$0.02
injection
$0.00
equipment
$0.00per recipient
$0.00
Increase of total cost per recipient compared to current schedule
5%
$0.09
$0.00
$0.00
3.4 Data output sheet – graphical illustration of results
Click on the Routine_illustration tab to display four bar charts showing key data
which has been calculated on a ‘per recipient’ basis: vaccine storage volumes,
volume of diluents and injection equipment, cost of vaccines and injection equipment
and the volume of waste generated.
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Figure 14 – Routine_illustration charts
Vaccine storage volumes
Volume of diluents and safe injection equipment per
recipient
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
Net volume of all vaccines, including OPV, stored at +5°C in lower level stores, per Unit of
Population
Net volume of all vaccines except OPV stored at +5°C in higher level stores, per Unit of
Population
2.0
4.0
6.0
8.0
10.0
12.0
Cost of vaccines and safe injection equipment per recipient
14.0
16.0
Volume, cm3
Total net storage volume of injection supplies per Unit of Population
, cm3
Estimate of the amount of injection waste generated per
recipient
HPV added
HPV added
Current schedule
Current schedule
$0.00
$0.00
$0.00
$0.01
$0.01
$0.01
$0.01
$0.01
$0.02
$0.02
0.0
$0.02
0.1
0.1
0.2
0.2
0.3
Total nbr. of used syringes generated, units/ Unit of Population
Nbr. of empty vials, units/ Unit of Population
Total cost of safe injection equipment per Unit of Population
Total cost of vaccines per 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
Total net storage volume of vaccines & diluents per recipient
Cost of vaccines and safe injection equipment per
recipient
30.0
40.0
50.0
60.0
70.0
80.0
H1N1 campaign
$0.01
$0.02
$0.03
Total cost of vaccines per recipient
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20.0
Estimate of the amount of injection waste generated
per recipient
H1N1 campaign
$0.00
10.0
Total net storage volume of injection supplies per recipient
$0.04
$0.05
$0.06
$0.07
$0.08
$0.09
$0.10
Total cost of safe injection equipment per recipient
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0.0
0.2
0.4
0.6
0.8
1.0
1.2
Total nbr. of syringes generated per recipient
Nbr. of empty vials generated per recipient
20 February 2012
1.4
3.5 How to use the graphs
This section describes how to use the graphs. There are a total of 12 graphs,
arranged in six pairs.
The first set of six graphs covers vaccine storage at primary and sub-national level,
district level and service delivery level. At each of these three levels one chart in the
pair (Type 1) compares the effect of different schedule with a common delivery
interval (designated different schedules with same Maximum stock on the charts).
The other graph in the pair (Type 2) covers the condition where a common schedule
is used, but different delivery intervals are modelled (designated same schedule with
different Maximum stocks on the charts). Refer to section 3.2.2b for a more detailed
description of the data entry requirements of the two graph types.
The second set of six graphs covers dry storage at primary and sub-national level,
district level and service delivery level. The graphs are arranged in the same three
pairs (Type I and Type 2) as described in the previous paragraph.
If you know the population of a specific facility, you can use the graphs to read off the
net vaccine or dry store volumes for that facility directly from the relevant chart for
any one of the scenarios you have chosen to model. Representative examples of the
two graph types are shown in Figures 16 and 17. Both charts show vaccine storage
capacity requirements at national and sub-national levels for the population range
entered in the Abacus_Tables worksheet. At these two upper levels in the supply
chain, polio vaccine is kept separately in a -20°C freezer or freezer room. The charts
show the capacity needed at +5°C only5. The figures on the vertical y-axis show the
net volume of vaccines in litres.
Figure 16 – Type 1 graph: different schedules with same Maximum Stock
Graph for cold storage capacity at national and sub-national stores - @ +5°C: (different schedules with same
Maximum Stock)
14,000
Net volume of vaccines, litres
12,000
10,000
8,000
6,000
4,000
2,000
10,500,000
10,100,000
9,700,000
9,300,000
8,900,000
8,500,000
8,100,000
7,700,000
7,300,000
6,900,000
6,500,000
6,100,000
5,700,000
5,300,000
4,900,000
4,500,000
4,100,000
3,700,000
3,300,000
2,900,000
2,500,000
2,100,000
1,700,000
900,000
1,300,000
500,000
-
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.
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Figure 16 shows the relationship between net storage capacity and population for the
existing schedule and for a proposed new schedule with HPV vaccine added. In the
example, the underlying calculation is on a ‘per individual vaccine basis’, as
described in section 3.2.2b STEP 2.
Figure 17 – Type 2 graph: same schedule with different Maximum Stocks
Graph for cold storage capacity at national and sub-national stores - @ +5°C: (same schedule with different
Maximum Stocks)
25,000
Net volume of vaccines, litres
20,000
15,000
10,000
5,000
10,500,000
10,100,000
9,700,000
9,300,000
8,900,000
8,500,000
8,100,000
7,700,000
7,300,000
6,900,000
6,500,000
6,100,000
5,700,000
5,300,000
4,900,000
4,500,000
4,100,000
3,700,000
3,300,000
2,900,000
2,500,000
2,100,000
1,700,000
1,300,000
900,000
500,000
-
Total population
Current schedule @ 4 months MaxiStock
Current schedule @ 6 months MaxiStock
Legend shows which
schedule is used
Current schedule @ 9 months MaxiStock
Target
population type
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.
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Figure 18 – Reading a graph
Graph for cold storage capacity at national and sub-national stores - @ +5°C: (different schedules with same
Maximum Stock)
14,000
Net volume of vaccines, litres
12,000
10,000
8,000
6,000
4,000
2,000
10,500,000
10,100,000
9,700,000
9,300,000
8,900,000
8,500,000
8,100,000
7,700,000
7,300,000
6,900,000
6,500,000
6,100,000
5,700,000
5,300,000
4,900,000
4,500,000
4,100,000
3,700,000
3,300,000
2,900,000
2,500,000
2,100,000
1,700,000
900,000
1,300,000
500,000
-
Total population
Current schedule @ per individual vaccine months-MaxiStock
HPV added @ per individual vaccine months-MaxiStock
3.6 Reference data worksheets
In addition to the ‘active’ worksheets, there are five further worksheets which contain
database information; these data are either used dynamically in the tool or by the
user in the field to identify equipment.
3.6.1 Passive_containers sheet:
This sheet provides data on WHO pre-qualified cold boxes and vaccine carriers
currently or historically available from all WHO pre-qualified manufacturers. This
worksheet is used as a look-up table to establish the net vaccine storage capacity,
icepack size and icepack numbers that are needed to complete the transport
capacity table in the Abacus_Tables worksheet.
3.6.2 PQEquipment sheet:
This sheet provides up-to-date information on refrigerators and freezers currently or
historically available from all WHO pre-qualified manufacturers. This worksheet is
used as a look-up table to extract the relevant equipment parameters needed to
calculate refrigerator and freezer needs once an equipment choice is made in the
Abacus_Tables worksheet.
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
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Note: this table is for information only – it is not directly used by the tool.

Table 3: Characteristics of walk in cold/freezer rooms

Table 4: Characteristics of icepack freezers

Table 5: Characteristics of vaccine shipping containers

Table 6: Purchase and running cost of cold chain equipment
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.
3.6.5 Vaccine_database sheet:
This sheet provides all necessary information on the vaccines currently available
from WHO pre-qualified manufacturers. The table include type; presentation; trade
name; mode of administration; packed volume per dose; availability of VVM, source
of data, etc. A link is also given to the relevant WHO webpage describing the
vaccine.
Users can update the database to include vaccines from other manufacturers,
including locally produced vaccines that may be used in individual countries.
Warning: Be very careful if you make additions and proceed as follows:

Unprotect the sheet

Insert a row where you want to add a vaccine. Make sure it is in the correct
place, e.g. Measles with other measles; JE with other JEs.

Make sure that you enter the correct vaccine initials in column C. Do not create
new initials. If you do, the vaccine will not appear on the drop-down list in the
Vaccine_Select worksheet. Enter all the necessary data specifying volume per
dose, diluent volume per dose, etc.

Protect the worksheet again when you have finished.
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.
3.6.7 Revision history
The Revision_history worksheet records a history of changes made to the tool.
6
At the time of writing, the Russian version was incomplete.
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Revision history
Date
Change summary
20.02.2012
New document
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Reason for change
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Approved
20 February 2012