Maintaining Vaccine Delivery Following the Introduction of the Rotavirus and Pneumococcal Vaccines in Thailand

Although the substantial burdens of rotavirus and pneumococcal disease have motivated many countries to consider introducing the rotavirus vaccine (RV) and heptavalent pneumococcal conjugate vaccine (PCV-7) to their National Immunization Programs (EPIs), these new vaccines could affect the countries' vaccine supply chains (i.e., the series of steps required to get a vaccine from their manufacturers to patients). We developed detailed computational models of the Trang Province, Thailand, vaccine supply chain to simulate introducing various RV and PCV-7 vaccine presentations and their combinations. Our results showed that the volumes of these new vaccines in addition to current routine vaccines could meet and even exceed (1) the refrigerator space at the provincial district and sub-district levels and (2) the transport cold space at district and sub-district levels preventing other vaccines from being available to patients who arrive to be immunized. Besides the smallest RV presentation (17.1 cm3/dose), all other vaccine introduction scenarios required added storage capacity at the provincial level (range: 20 L–1151 L per month) for the three largest formulations, and district level (range: 1 L–124 L per month) across all introduction scenarios. Similarly, with the exception of the two smallest RV presentation (17.1 cm3/dose), added transport capacity was required at both district and sub-district levels. Added transport capacity required across introduction scenarios from the provincial to district levels ranged from 1 L–187 L, and district to sub-district levels ranged from 1 L–13 L per shipment. Finally, only the smallest RV vaccine presentation (17.1 cm3/dose) had no appreciable effect on vaccine availability at sub-districts. All other RV and PCV-7 vaccines were too large for the current supply chain to handle without modifications such as increasing storage or transport capacity. Introducing these new vaccines to Thailand could have dynamic effects on the availability of all vaccines that may not be initially apparent to decision-makers

Multi-period line planning with resource transfers

Urban transportation systems are subject to a high level of variation and fluctuation in demand over the day. When this variation and fluctuation are observed in both time and space, it is crucial to develop line plans that are responsive to demand. A multi-period line planning approach that considers a changing demand during the planning horizon is proposed. If such systems are also subject to limitations of resources, a dynamic transfer of resources from one line to another throughout the planning horizon should also be considered. A mathematical modelling framework is developed to solve the line planning problem with a cost-oriented approach considering transfer of resources during a finite length planning horizon of multiple periods. We use real-life public transportation network data for our computational results. We analyze whether or not multi-period solutions outperform single period solutions in terms of feasibility and relevant costs. The importance of demand variation on multi-period solutions is investigated. We evaluate the impact of resource transfer constraints on the effectiveness of solutions. We also study the effect of period lengths along with the problem parameters that are significant for and sensitive to the optimality of solutions