Vaccine wastage and how it is managed in India

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World’s largest vaccination drive in India is in full swing. More than 8 crores of vaccines have been administered in the country so far. People above the age of 45 years are now eligible to take their vaccine shots.

Yet, one of the major concerns in the Covid-19 inoculation drive that was flagged by Prime Minister Narendra Modi recently is vaccine wastage.

In India, the national average for Covid-19 vaccine wastage is around 6.5% to which the government have asked all the states to keep up the wastage below 1%. According to the Ministry of Health data, Telangana (17.6 per cent), Andhra Pradesh (11.6 per cent), Uttar Pradesh (9.4 per cent), Karnataka (6.9 per cent) and J&K (6.6 per cent) are the states with the highest vaccine wastage.

However, vaccine wastage is a part and parcel of any large vaccination drive worldwide.

What is Vaccine Wastage?

Vaccine wastage is a normal phenomenon of any large vaccination drive but it starts raising eyeballs when a certain recommended limit is crossed. Every vaccine is procured from the manufacturer with an estimated wastage.

To sum it up—

High vaccine wastage inflates demand for more vaccination.
Resulting in the manufacturing of more vaccines thus, increasing the supply chain costs.

How the vaccine waste is calculated?

There is a mathematical formula for the calculation of vaccine wastage.

WMF- Wastage Multiple Factor

WMF= 100/(100 – wastage)

As per the Indian government operational guidelines on Covid-19 vaccination, WMF is calculated at 1.11. This is done after assuming an allowable or set programmatic wastage of 10%.

With this WMF = 100/(100 – 10) = 1.11.

From a total of 100, 10 vaccines are allowed to be wasted if the number increases then that is called vaccine wastage.

Now, the requirement of number of vaccination required in a month in a particular catchment area is calculated by –

Requirement = (Total population to be covered in the catchment area) × (% of the population to be covered in this catchment area/no. of months of the campaign) × 2 doses × WMF.

Why does vaccine wastage happen?

There are multiple factors that can affect a dose of vaccine. The two broadly classified categories are Wastage in unopened vials and waste in opened vials.

Under unopened vial wastage the reasons can be:

Extreme temperature
Expiry date
Breakage during transit
Leakage
Missing records or theft
Discarding unused vials returned from vaccination sites.

Under opened vial wastage the reasons can be:

During discarding the leftover vaccine doses at the end of each session
Not being able to completely draw the vaccine in the vial
If an open vial is submerged in the water.
Contamination
Poor administration practices

Reasons for the vaccine wastage:

The wastage of vaccine is directly proportional to the session size i.e. the number of beneficiaries per session and the vial size. The centre has identified two major reasons for vaccine waste:

-Inadequate planning of sessions

For example- A vial contains does for 10 people and only 6 turns up for vaccination then 4 doses are wasted. To tackle such issues, the government of India have advised the states to mobilise people and not open the vials if they don’t have enough people. They can ask the people to come the next day to take the shots rather than wasting the vaccine doses.

-Inadequate training

The trained vaccinators know how to draw a vaccine. But an untrained vaccinator would end up drawing only 9 doses against the 10, resulting in wastage.

How Vaccine wastage is managed in India

-The vaccination policy should be followed by all the public and private centres strictly. Open vial policy guidelines have to be strictly followed to minimise vaccine wastage

-The government of India have urged all the states to ensure timely utilization of available stocks in order to avoid vaccine expiry.