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The MEMS uses a microprocessor in the medication container cap to record day and time of each vial opening.
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Often 20-dose vials of BCG are not opened unless at least ten children are present for vaccination ("restricted vial-opening policy").
We evaluated how not adhering to the restrictive vial-opening policy affected BCG coverage and affected factors associated with delayed BCG vaccination.
We assessed BCG coverage at different ages among children born in 2010 in rural Guinea-Bissau to identify factors associated with delayed BCG vaccination in a context with a restrictive vial-opening policy.
We speculate that the restricted vial-opening policy is one of the main obstacles to early BCG vaccination but the information disclosed to the mothers does not allow any final conclusion.
Due to the restricted vial-opening policy some vaccines are only provided once a week at health centres and only if there is a sufficient number of eligible children present.
However, BCG vaccination is often delayed for several reasons, one of them being the "restrictive vial-opening policy": BCG is a freeze-dried vaccine supplied in vials with 20 infant doses [ 1] and once reconstituted, the vaccine should only be used for a maximum of six hours.
The residues were re-dissolved in 1 mL ethyl acetate by pipetting and transferred into 2 mL standard opening vials prior to quantitation by gas chromatography (GC Varian Association Inc. USASA) equipped with pulse flame photometric detector (PFPD).
BCG coverage was assessed for children born in 2010, when the restricted vial-opening policy was universally implemented, and in 2012 2013, where BHP provided BCG to all children at monthly visits in selected intervention regions.
Vials have an opening in the cap with a pierceable silicone/Teflon septum (Fig. 4).
Whereas wastage occurs essentially after the opening of vials (98%), the correct application of the open vial policy in a majority of health centers explains why OPV wastage was contained within accepted limits for the district.
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