COVID-19: How vaccine wastage happens, how to reduce it

Centre and states are making efforts to step up COVID-19 vaccination even as supplies remain limited. One of the factors which can help increase the vaccination pace is reduction in wastage of vaccines.

The Centre has been urging states to reduce vaccine wastage. On Tuesday, Union Health Secretary Rajesh Bhushan and Dr R S Sharma, the Chairman of Empowered Group on Technology and Data Management to Combat COVID-19, in a meeting with state officials to review the status of COVID-19 vaccination highlighted the need to bring down vaccine wastage.

While the overall wastage levels have considerably reduced, Bhushan pointed out that there are many states which need to substantially reduce the wastage. States and union territories have been asked to retrain and reorient vaccinators to ensure judicious usage of the vaccines and were told that from now on all wastage more than the national average will be adjusted from the subsequent allocations to that state or union territory.

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As of May 11, Haryana has reported the highest vaccine wastage at 6.49 per cent, followed by Assam (5.92 per cent), Rajasthan (5.68 per cent), Meghalaya (5.67 per cent), Bihar (5.20 per cent). We take a look at how vaccine wastage takes place and how it can be reduced:

What is vaccine wastage

Vaccine wastage happens in all vaccination programmes across the world and is unavoidable. However, with proper planning and care, the wastage can be reduced. As per the guidelines issued by the Ministry of Health and Family Welfare (MoHFW) in January this year, at least 10 per cent of COVID-19 vaccines procured by the Centre may face "programmatic wastage". In fact, wastage is taken into consideration by the Centre while allotting vaccines to states. Wastage Multiplication Factor (WMF) is taken into consideration while planning the vaccination programme.

As per MoHFW's guideline, WMF = Wastage Multiplication Factor = 1.11 for COVID-19 vaccine, assuming an allowable programmatic wastage of 10% [WMF = 100/(100 - wastage) = 100/(100-10) = 100/90 = 1.11].

How does vaccine wastage happen

Vaccine wastage can happen during transportation, storage and at vaccination centres. The COVID-19 vaccines are supplied in multi-dose vials, with each vial having 10 doses of vaccine. There are chance of vials breaking or getting damaged while transportation. The vaccine also needs to be stored in a particular temperature range. Failure to maintain the needed temperature during transportation, storage or at vaccination centre may result in it getting wasted. Besides, pilferage can also not be ruled out. The theft of COVID-19 vaccine vials from the storeroom of a hospital in Haryana's Jind district recently is an example. Contamination of vaccine after opening it is another way in which vaccines can become ineffective and will have to be discarded.

Also read: Thief who stole vaccines from Haryana hospital returns vials, leaves note apologising

A vial of COVID-19 vaccine has to be used within a fixed time period (about 4 hours) after opening it. If 10 people are not available to get inoculated during the time period, then the left over doses will be wasted. This is a big issue when the vaccine hesitancy is high or in remote areas which are not densely populated.

How to reduce wastage

One of the ways to reduce the wastage is to take all available measures to make sure vials are not damaged during transportation. Besides correct temperature should be maintained while storing the vaccine and a temperature log should be maintained so that any deviations are quickly noticed and corrective measures taken. Any damaged storage equipment should be quickly replaced.

Another way to reduce the wastage is proper planning. Vials with earlier expiry date should be used before the ones with a later expiry date. As each vial contains 10 doses of vaccine, many states like Kerala, Himachal Pradesh have been following the practice of opening a new vial only when there are a certain number of beneficiaries present to get vaccinated. Staggered and continuous movement of beneficiaries can ensure that there are at least 10 beneficiaries available within the 4-hour time period during which the vaccine has to be administered after opening the vial.

Besides, while every vial is labelled to have 10 vaccine doses, if used judiciously, 11 to 12 doses can be extracted from the vial. Filling extra vaccine in a vial is a common practice. It is done to facilitate inoculation of correct number of doses. States like Kerala, West Bengal, Himachal Pradesh have registered negative vaccine wastage by extracting every possible dose from a vial and inoculating higher number of beneficiaries. Recently, Kerala Chief Minister Pinarayi Vijayan had tweeted on how the state had inoculated more number of people by making use of the extra dose available as wastage factor in each vial.

Kerala has received 73,38,806 doses of vaccine from GoI. We've provided 74,26,164 doses, even making use of the extra dose available as wastage factor in each vial. Our health workers, especially nurses have been super efficient and deserve our wholehearted appreciation!

- Pinarayi Vijayan (@vijayanpinarayi) May 4, 2021

Responding to the tweet, Prime Minister Narendra Modi, who has also called repeatedly to reduce vaccine wastage, said it was good to see healthcare workers and nurses set an example in reducing vaccine wastage.

Good to see our healthcare workers and nurses set an example in reducing vaccine wastage.

Reducing vaccine wastage is important in strengthening the fight against COVID-19. https://t.co/xod0lomGDb

- Narendra Modi (@narendramodi) May 5, 2021

India has administered 17.52 crore doses of COVID-19 vaccines as of morning of May 12. At a time when the country is striving and struggling to ramp up the pace of vaccination, it has become imperative to reduce vaccine wastage, wherever possible, by adopting the best practices.

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