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In a meeting with chief ministers on Wednesday, Prime Minister Narendra Modi raised concerns about the wastage of vaccines resulting from the Covid-19 vaccination campaign. What are the concerns and how is waste determined?
What is vaccine wastage?
Vaccine wastage is an expected component of any large-scale vaccination campaign, and a vaccine is purchased from the manufacturer with estimated wastage. For each type of vaccine, wastage should be within recommended limits.
In general, high vaccine wastage inflates vaccine demand and increases unnecessary vaccine purchases and supply chain costs.
Vaccine wastage is directly related to vaccine use, which is the proportion of vaccines given versus vaccines delivered at a vaccination site. The vaccine wastage rate is defined as 100 minus the vaccine utilization rate. And the wastage rate directly determines the “wastage factor” that must be established for each vaccine in the immunization schedule in order to accurately plan vaccine needs.
How is the loss factor calculated? How much is in the current program?
Wastage Multiple Factor (WMF) is calculated from the formula WMF = 100 / (100 – wastage). In the operational guidelines of the Center on Covid-19 Vaccination, the WMF was calculated as 1.11 after assuming an allowable programmatic wastage of 10%, so that WMF = 100 / (100 – 10) = 1.11 .
Vaccine wastage is one of the key factors to consider when forecasting vaccines and estimating needs. The number of Covid-19 vaccines required in a month in a catchment area (state / district / block / sector) for a month is calculated from the formula:
Need = (total population to be covered in the watershed) × (% of the population to be covered in this watershed / number of months in the campaign) × 2 doses × WMF. 📣 Express explained is now on Telegram. Click here to join our channel (@ieexplained) and stay up to date with the latest
How does vaccine wastage occur?
It is broadly divided into two categories: wastage in unopened vials and in open vials.
Spillage in unopened vials can occur for six main reasons: if the expiration date has been reached; if the vaccine is exposed to heat; whether the vaccine has been frozen; rupture; missing inventory and theft; and discarding unused vials returned from the vaccination site.
There are five main reasons for wastage in opened vials: when the remaining doses are discarded at the end of the session; not being able to draw the number of doses in a vial; submersion of open vials in water; suspected contamination; and poor vaccine administration practices.
At what stages can waste occur?
Waste occurs at three levels: during transport; during cold chain point; and at an immunization site – both at the service and delivery level.
At the cold chain point, the operational guidelines state: The issue of vaccine doses should correspond to the recorded list of beneficiaries (rounded to the nearest whole number of vials) without any adjustment for vaccine wastage in terms of WMF and vaccine vials with earlier manufacturing dates should be prioritized for issuance first.
In district vaccine stores, guidelines state: Vaccine doses delivered should equal the number of beneficiaries recorded for each point in the cold chain (rounded to the nearest number of vaccine vials) with no adjustment for wastage of vaccines in terms of WMF. The amount of emission will depend on the frequency of supply (e.g. weekly estimate of registered beneficiaries at cold chain points in the district), and vaccine lots with previous manufacturing dates should be prioritized for release. show first.
On the site of the vaccination session, the guidelines for the operation stipulate: Each vaccination session must concern a maximum of 100 beneficiaries; however, in the case of remote and sparsely populated areas, the state could organize sessions for a smaller number of beneficiaries while ensuring that there is no wasted vaccine. If the number of beneficiaries at a session is low, then that session site will be clubbed with other sessions.
Why are some states showing higher vaccine wastage?
At the vaccination site, vaccine wastage has a direct relationship to the size of the session – the number of beneficiaries per session – and the size of the vial.
The first reason identified by the Center is inadequate session planning. For example, if the vial contains doses for 10 people and only six are present, four doses may be wasted. The Center advised states to mobilize people and not open the vials if they don’t have 10 people. “We have advised states to ask recipients to wait about half an hour; if no one comes, then we have asked the states to give the beneficiary the opportunity to come the next day, where they will be allocated the first places. It all comes down to granular planning at the vaccination center level. This is the kind of planning that is needed, ”said a senior health ministry official.
The second reason identified by the Center is inadequate training. Officials said vaccinators ended up shooting, perhaps, just nine doses versus ten doses. “We find that those who are trained vaccinators know how to draw a vaccine. These trained vaccinators will tell you that even in a ten-dose vial, you can take out 11. This is critical to reducing vaccine wastage, ”the official said.
In addition, policy guidelines regarding opened vials should be strictly followed to minimize vaccine wastage. In the Covid-19 vaccination campaign, the Department of Health fact sheet sent to states states that Covishield and Covaxin must be discarded after four hours of operation.
What are the concerns raised by the Prime Minister and his suggestions to the States?
Modi specifically pointed out that vaccine wastage in Telangana, Andhra Pradesh and Uttar Pradesh is in the order of 10%. “States need to look at why the vaccine is wasted and there needs to be a mechanism to keep it under control every night. Because by wasting the doses of the vaccine, we are denying another beneficiary the right to be vaccinated. States must immediately correct the drawbacks of local planning and governance to reduce vaccine wastage. States must aim for zero percent waste, ”he said.
Modi called on states to increase vaccination centers and stay vigilant about the vaccine’s expiration date. “… We need to increase the number of vaccination centers, both in private and government facilities. If we, the Center, work proactively, there will be a reduction in vaccine wastage. There is also the issue of the expiration date of vaccines: doses that arrive first should be used first; however, if states use doses that arrived later, then again, there could be a wastage situation, ”he said.
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