Rwanda to Track 30,000 Vaccine Doses Through Cold-Chain System

Vaccines prevent many infectious diseases, but for any vaccine to work it needs to be carefully stored and transported within a controlled temperature range (typically 2-8°C). This vaccine cold-chain is uninterrupted from vaccine manufacture and throughout the country-wide distribution networks which keep vaccines effective up to the point of use.

The VaccMap project will aim to use powerful digital tracking and accountability technology to systematically determine the precise burden of open- and closed-vaccine vial losses, and where and how these losses occur. Open-vial losses are when there are not enough individuals to vaccinate after giving the first dose from a vial, and the leftover unused doses in the vial need to be discarded because they have been removed from the cold-chain for too long. Closed vial losses, the loss of a whole vaccine vial before being opened, can commonly cost up to 6-10 doses each time and are usually due to physical damage, vaccine expiry or loss of temperature control at some point in the cold-chain.

Toby Peters, Professor in Cold Economy at the University of Birmingham, and Co-Director of the Centre for Sustainable Cooling said: “The vaccine cold-chain underpins vaccine policy and is part of any country’s critical national infrastructure. This cold-chain is vital for every birth in every country in the world. However, 20% of African children do not receive a complete immunization schedule and more than 30 million children under five years old suffer from vaccine-preventable diseases every year, 68% of which are in Africa.

“An estimated 25% or more vaccine doses are compromised by failures in cold-chain custody (freezing or excess heat exposure). Through this project we hope to get a better understanding of where these losses occur in the Rwandan cold-chain, to prevent them from happening and design future cold-chain systems to ensure more people can access effective vaccines sustainably.”

The project, which started in December 2023, is delivered in collaboration with the Africa Centre of Excellence for Sustainable Cooling and Cold-Chain (ACES), Rwanda Biomedical Center, Circulor and Crown Agents.

Christopher Green, Associate Clinical Professor in Infectious Diseases at the University of Birmingham, is the Principal Investigator for the study. He added: “There are a lot of exciting new vaccine technologies that were accelerated during the COVID pandemic and are now being re-designed to target many major outstanding global health priorities. This study is very important in our wider work to prepare African healthcare systems for the deployment needs of these technologies and manage the concurrent challenges caused by climate change. We have excellent collaborations from our project partners for this difficult problem.”

The software used in the project, developed by project partner Circulor, was originally designed for tracking components needed to make car batteries through complex supply chains. The Circulor team have modified their technology so that it can be used in critical vaccine supply chains. The life of every vaccine vial is recorded, which includes accountability for every fraction of each vaccine vial (or a dose), to build an accurate real-world picture of how to strengthen vaccine security and efficiency.

The study is taking place in the Rwamagana District of Rwanda, at the Rwamagana District Hospital and the 16 Health Centers in this network in the East of the country. The study team comprises over 40 front-line healthcare staff from the Rwanda Ministry of Health and will run until March 2024.