• Patrick Lydon, Simona Zipursky, Carole Tevi-Benissan, Mamoudou Harouna Djingarey, Placide Gbedonou, Brahim Oumar Youssouf, and Michel Zaffran.
• Expanded Programme on Immunization Plus, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland .
• Bull. World Health Organ. 2014 Feb 1; 92 (2): 86-92.

ObjectiveTo evaluate the potential economic benefits of keeping a meningitis A vaccine at or near ambient temperature for up to 4 days during a mass vaccination campaign.MethodsDuring a 10-day mass vaccination campaign against meningitis A in three regions of Chad in 2011, the costs associated with storage and transport of the vaccine in a traditional cold chain system were evaluated. A mathematical model was used to estimate the savings that could have been achieved if the vaccine had been stored at or near ambient temperature--in a "controlled temperature" chain--at the peripheral levels of the supply chain system.FindingsThe cost of the cold chain and associated logistics used in the campaign in Chad was 0.24 United States dollars (US$) per person vaccinated. In the modelled scenario for a controlled temperature chain, however, these costs dropped by 50% and were estimated to be only US$ 0.12 per person vaccinated.ConclusionThe implementation of a "controlled temperature" chain at the most peripheral levels of the supply chain system--assuming no associated loss of vaccine potency, efficacy or safety--could result in major economic benefits and allow vaccine coverage to be extended in low-resource settings.

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