Procurement of influenza vaccine should in general be based on forecasting, tendering, contracting and ordering procedures similar to those for other vaccines in the immunization programme (Toolbox). Forecasting is critical to prevent stock-outs or overstocks of the vaccine. Forecasting is based on the estimated number of pregnant women, the estimated vaccine uptake and wastage (unused vaccine in both opened [multi-dose] and unopened vials).
The accuracy of vaccine forecasting and needs estimation depends on both the level of implementation and the time period for estimation. It is necessary to track the actual consumption of influenza vaccine and to monitor stocks at different levels of the supply chain and at health facilities in order to redistribute them according to actual consumption during the time the vaccine is available.
The price of influenza vaccine can vary according to several factors, and should be taken into consideration when deciding to procure the vaccine. The WHO Vaccine Product Price and Procurement (V3P) database provides information on vaccine prices. Influenza vaccine formulations and presentations (multi-dose or single dose) should be selected that are least likely to result in programmatic errors and that correspond to the training levels and capacities of the health-care workers providing immunization, particularly when delivered through a previously unused channel.
When selecting the vaccine to be used in a campaign, ease of use of a vaccine should be balanced against risk of wastage. It is particularly important to keep in mind the following: vial size (doses/vial), vaccine delivery method (injectable vaccine), vaccine wastage versus missed opportunities for vaccination (e.g. health-care workers reluctant to open and be forced to discard the remainder of a multi-dose vial in case of low-volume of pregnancy visits in a clinic setting.)