Vaccine Wastage
- September 19, 2021
- Posted by: OptimizeIAS Team
- Category: DPN Topics
No Comments
Vaccine Wastage
Subject – Science and Tech
Context – On one hand, India’s COVID-19 vaccine shortage is impeding the success of the ongoing immunisation drive. On the other, there are reports of vaccine wastage.
Concept –
- The WHO describes vaccine wastage to be the “sum of vaccines discarded, lost, damaged or destroyed.”
- On one hand, India’s COVID-19 vaccine shortage is impeding the success of the ongoing immunisation drive. On the other, there are reports of vaccine wastage.
- According to the latest figures, Jharkhand with 37.3 percent and Chhattisgarh with 30.2 percent recorded the highest vaccine wastage in the country. Certain states like Kerala with -6.3 percent and West Bengal with -5.4 percent recorded a negative wastage.
- Accurately calculating the wastage rate is essential for reducing stock-outs and over-stock, choosing the most appropriate vaccine presentation and immunisation session size, as well as sizing supply chain infrastructure at country level.
- All vaccination drives do account for some amount of wastage but keeping it to a minimum is imperative, especially in a crisis like the COVID pandemic where it is necessary for the government to immunise the whole country on an urgent basis.
How Does Vaccine Wastage Happen?
- Several factors can lead to vaccine wastage in both opened and sealed vials.
- Logistical issues such as a weak cold chain, breakage during transportation, unused doses crossing the expiry date, or missing inventory can lead to vaccine wastage.
- Alternately, wastage in opened vials can happen because of immunisation workers’ practices. Discarding opened vials without optimal use of the doses, suspected contamination, health workers not being able to draw the number of doses indicated on the label of a vial, can all lead to wastage.
- Vaccine usage is calculated as the proportion of vaccines administered out of the total vaccines allotted.
- Therefore, the percentage of vaccines not administered at all is called the ‘rate of vaccine wastage’. The vaccine wastage rate is defined as ‘100 minus the vaccine usage rate’, as per the WHO definition.
- The most common problem seen especially in the COVID vaccination drive is incorrect planning. Sometimes the vial is opened but there are only a few beneficiaries, so the remaining doses in the vial go to waste.
- Another factor is that once opened the vial should be used within four hours, so if the number of people who turn up for vaccination is low, there will be vaccine wastage.
How Can Vaccine Wastage Be Reduced?
- Careful transportation and maintaining proper temperatures are needed to reduce vaccine wastage.
- Planning vaccine sessions carefully where health workers open a vial only after a certain amount of beneficiaries are available to ensure full usage of the all the doses available in a vial can also bring down wastage.
Can extra doses in the vial be used?
- In multi-dose vials, there can be a difference between the number of doses stated on the vaccine label and the true number of doses that can be withdrawn.
- The true number of doses available from a multi-dose vial will depend on several factors such as syringe dead space, vial overfill volume, and technique and accuracy of doses withdrawn and delivered.
- If you can withdraw additional accurate vaccine dose(s) after having withdrawn the number of doses listed on a vaccine vial label, you can administer them. It is important to ensure that the vaccine is appropriately stored while in use and that the multi-dose vial policy is respected.
- Further, make sure that use of these doses is in accordance with your national policy.
- If an accurate dose cannot be withdrawn from a vial, do not combine residual vaccine from multiple vials. Discard any remaining vaccine.
- Remember that pre-loading of syringes is not recommended. When you are ready to vaccinate, ensure that you always draw up the accurate vaccine dose (e.g. 0.5mL) and administer immediately.
What is vial overfill volume?
- Filling extra vaccine in a vial is a common practice in vaccine production and is called ‘overfill’.
- Manufacturers include extra vaccine to aid health workers in delivering the intended number of accurate doses.
- Overfill accounts for vial-retained volume (the vaccine left in a vial that cannot be withdrawn), vaccine retained in the dead space of the syringe and needle, and losses of vaccine during the adjustment of the dose if ejected in the air.
What is syringe dead space?
- Syringe dead space represents a volume of vaccine retained in the syringe after administration.
- It can vary among devices: in ‘high dead space’ syringes vaccine remains within the needle and between the syringe hub and the plunger, and ‘low dead space’ syringes are designed so that the space between syringe hub and the needle is limited.