Vaccine wastage explained

Vaccine wastage is the number of vaccines that have not been administered during vaccine deployment in an immunization program. The wastage can occur at multiple stages of the deployment process, and can take place in both unopened and opened vials, or in oral admission. It is an expected part of vaccination deployment and is factored into the manufacturing process.[1] [2] __TOC__

Prevalence

A 2018 study into Cambodia's national immunization program found wastage rates of 0% to 60% depending on location and vaccination type.[3]

A study from India which collected Universal Immunisation Programme data from two different locations (Kangra and Pune districts) between January 2016 to December 2017 found wastage rates that differed according to vaccine type, reuse type, vial size, transition from IPV (inactivated polio vaccine) dosage to fIPV (fractional inactivated polio vaccine) and according to the geographical location.[4] In both districts wastage increased as vial size increased from 5 to 10 dose vials. In Kangra, wastage observed in oral polio vaccine was 50.8% while in Pune it was 14.3%. Wastage for a number of other vaccinations in the program was higher than what had been factored into the initial programme forecasting.

Parts of the United States has vaccine wastage tracking factored into the deployment process. Reasons for vaccine wastage are categorised as— broken vial/syringe, lost or unaccounted for, open but not all doses administered, or drawn into a syringe but not administered.[5] [6] Other reasons for wastage include contamination, expiration and temperature issues. Vaccine wastage in the United States during its 2021 COVID-19 vaccination program is less than 1%, and reported as low as 0.1%.[7] [8] [9] In India covid vaccine wastage was 6.5% while in Scotland and Wales it was 1.8%.

Reduction

Improving requirement estimates, transportation and logistics, wastage reporting, optimal session sizes and usage of syringes and needles with low dead volume are important factors in reducing wastage.[10] [11] While manufacturing single dose vials would considerably reduce vaccine wastage, it would increase the cost of the manufacturing process. However there are cases when single dose vials are optimum such as when administering vaccines to a limited number of people or single person sessions.[12]

Notes and References

  1. Web site: 2005. Monitoring vaccine wastage at country level : guidelines for programme managers.. 5 May 2021. World Health Organization. 10665/68463.
  2. Web site: 2021-03-27. Quixplained: What is vaccine wastage, and how can it be prevented?. 2021-06-05. The Indian Express. en.
  3. Wallace. Aaron S.. Krey. Kong. Hustedt. John. Burnett. Eleanor. Choun. Narin. Daniels. Danni. Watkins. Margaret L.. Soeung. Sann Chan. Duncan. Richard. 2018-07-16. Assessment of vaccine wastage rates, missed opportunities, and related knowledge, attitudes and practices during introduction of a second dose of measles-containing vaccine into Cambodia's national immunization program. Vaccine. 36. 30. 4517–4524. 10.1016/j.vaccine.2018.06.009. 0264-410X. 6032508. 29907485.
  4. Das. Manoja Kumar. Sood. Mangla. Tambe. Muralidhar Parashuram. Sharma. Thakur Dutt. Parande. Malangori Abdul Gani. Surwade. Jitendra Bhaskar. Salunkhe. Nandakumar Manikrao. Patil. Shital Somsing. Pawar. Bhagwan. Guleri. Rajesh. Kaushal. Chitra. 2020-04-25. Documentation of vaccine wastage in two different geographic contexts under the universal immunization program in India. BMC Public Health. 20. 1. 556. 10.1186/s12889-020-08637-1. 1471-2458. 7183620. 32334554 . free .
  5. Web site: Reagan. Nick. 9 May 2021. Clinics look to minimize vaccine wastage. 2021-06-06. WTOC. Wasted doses must be reported in one of four categories: Broken vial/syringe, lost or unaccounted for, open but not all doses administered, or drawn into a syringe but not administered..
  6. Web site: New York State COVID-19 Vaccination Program- Reporting Vaccine Wastage. COVID-19 Vaccine Wastage Reporting Guidance, Updated 2-15-21.. 6 June 2021. coronavirus.health.ny.gov.
  7. Web site: Young. Elise. 22 April 2021. Vaccine Waste at 0.1% Fails to Ease the Worries of U.S. Doctors. registration. 2021-06-06. Bloomberg.
  8. Web site: Anderson. Maia. 22 April 2021. 1 in 850 COVID-19 vaccine doses wasted in US, CDC data shows. 2021-06-06. Beckers Hospital Review.
  9. Web site: Timsit. Annabelle. 28 May 2021. Covid-19 vaccine waste is about to go up in the US. 2021-06-06. Quartz. en.
  10. Book: World Health Organization Department of Immunization, Vaccines and Biologicals. Immunization in Practice: A Practical Guide for Health Staff - 2004 Update. 2004-09-30. World Health Organization. 978-92-4-154651-5. 31–32. en.
  11. Web site: Turp-Balazs. Craig. 2021-01-20. Emerging Europe's EU members will have a key role to play in distributing Covid-19 vaccines to their eastern neighbours. 2021-06-07. Emerging Europe.
  12. Dhamodharan. Aswin. Vaccine wastage reduction in immunization sessions through vaccine vial size optimization. 2011. Rochester Institute of Technology. "The choice of a single dose vial reduces the likelihood of open vial vaccine wastage; but it increases the vaccine purchase cost per dose compared to that of larger vial sizes [...] First, single dose vials are usually optimal for smaller session sizes. For a given session size, OVW always increases with increase in vial size. Secondly, session size and purchase cost function are the two most important factors that affect the optimal vial size."

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