Putting safety first: ensuring safe vaccination practices during the 2006 rubella campaign in Bolivia.

Over 3 weeks in 2006, 3826083 persons were vaccinated against rubella during a national immunization campaign in Bolivia. This campaign was the largest mass immunization campaign ever conducted in the country. Therefore, in addition to strategic and micro-planning and financial and social mobilization, issues of safety (eg, safe injection practices and waste management) were at the forefront of campaign preparations. Waste management practices were promoted through guidelines, training, and implementation of locally appropriate solutions. These experiences show that, with detailed planning and preparation, in addition to collaboration among key partners, effective management of waste during campaigns in low-income countries is both feasible and beneficial. However, challenges remain in implementing environmentally appropriate solutions. This campaign served as the launching pad for a focus on ensuring that proper waste management practices are used both in the routine immunization program and in subsequent campaigns across Bolivia.