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Bull World Health Organ. 1999;77(1):29-33.

Use of SoloShot autodestruct syringes compared with disposable syringes, in a national immunization campaign in Indonesia.

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Program for Appropriate Technology in Health/Lombok, Mataram, Indonesia.


Autodestruct syringes can reduce the improper reuse of syringes, which present a significant risk in the transmission of bloodborne pathogens in developing countries, especially during immunization campaigns owing to the high number of injections given per session. SoloShot is an autodestruct syringe, distributed by UNICEF, which has been shown to be safer and easier to use than standard syringes. This study analyses the accuracy and dose-efficiency of SoloShot, compared with disposable syringes, during a national tetanus toxoid immunization campaign on the Indonesian island of Lombok. Observation and dose measurements revealed that SoloShot syringes delivered more precise and consistent doses and 15% more doses per vial than disposable syringes. Vaccine savings may partially be offset by the higher price of SoloShot. Vaccinators preferred SoloShot, describing it as easier to use, faster, and more accurate than the disposable syringe. The study indicates that SoloShot is highly appropriate for use in immunization campaigns by reducing vaccine wastage and improving injection safety.


The reuse and improper sterilization of syringes used in immunization campaigns present significant risks of transmission of blood-borne pathogens. This study assessed the accuracy and dose-efficiency of SoloShot, an autodestruct syringe distributed by UNICEF, during a 1996 national tetanus toxoid immunization campaign on the Indonesian island of Lombok. The eight vaccinators were Indonesian Ministry of Health personnel and midwives from subdistrict health centers. Sites were randomly assigned to SoloShot or the disposable syringe. During the 4-day campaign, a total of 385 doses were delivered with SoloShot and 433 with the disposable syringe. SoloShot delivered an average of 1.02 (15%) more doses per vial than the disposable syringe and provided a mean dose closer to the ideal of 0.5 ml. As a result of a greater amount of dead space in the disposable syringe, an average of 2.6 doses of vaccine per vial were wasted compared with 1.2 doses for SoloShot. A questionnaire on user acceptability revealed that vaccinators preferred SoloShot on six of the nine indicators, including overall preference. SoloShot was considered faster, easier to use, and more accurate than the disposable syringe. Overall, these findings suggest that use of SoloShot in national immunization campaigns could reduce vaccine wastage while improving injection safety.

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