Improving Situation Analysis and Operational Efficiency of Immunization in India: Disease Correlation and Vaccine Supply Chain Modeling

Abstract

India has one of the largest immunization programs in the world yet fully immunizes only 61% of its 27 million newborns each year. Additional expansion and performance monitoring of services to local levels is still needed in India in order to reach the WHO goal of at least 80% of children for routine coverage (M. Miller & Sentz, 2006). Statistical analyses and supply chain models can result in improved decision-making for an array of immunization policy issues through evidence of disease burden, vaccine impact, and financial and programmatic considerations. I look at the impact of disease-specific immunization through correlation and linear regression of immunization rates with number of disease cases and deaths in India. I then construct a computational model of the vaccine supply chain in the Indian state of Bihar, calculate a logistics cost per vaccine dose delivered, and look at alternate transport scenarios. The model can be used as a precursor for HERMES vaccine supply chain models that help determine which factors have the greatest impact on cost and coverage, and to generate further sensitivity analyses.