Vaccine wastage

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Components of a smallpox vaccination kit Smallpox vaccine.jpg
Components of a smallpox vaccination kit
Oral polio vaccine Poliodrops.jpg
Oral polio vaccine

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]

Contents

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. [4] 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. [4]

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. [6] 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%. [7]

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]

Related Research Articles

<span class="mw-page-title-main">Vaccine</span> Pathogen-derived preparation that provides acquired immunity to an infectious disease

A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as a threat, destroy it, and to further recognize and destroy any of the microorganisms associated with that agent that it may encounter in the future.

<span class="mw-page-title-main">Polio vaccine</span> Vaccine to prevent poliomyelitis

Polio vaccines are vaccines used to prevent poliomyelitis (polio). Two types are used: an inactivated poliovirus given by injection (IPV) and a weakened poliovirus given by mouth (OPV). The World Health Organization (WHO) recommends all children be fully vaccinated against polio. The two vaccines have eliminated polio from most of the world, and reduced the number of cases reported each year from an estimated 350,000 in 1988 to 33 in 2018.

<span class="mw-page-title-main">Immunization</span> Process by which an individuals immune system becomes fortified against an infectious agent

Immunization, or immunisation, is the process by which an individual's immune system becomes fortified against an infectious agent.

<span class="mw-page-title-main">DPT vaccine</span> Class of combination vaccines

The DPT vaccine or DTP vaccine is a class of combination vaccines against three infectious diseases in humans: diphtheria, pertussis, and tetanus. The vaccine components include diphtheria and tetanus toxoids and either killed whole cells of the bacterium that causes pertussis or pertussis antigens. The term toxoid refers to vaccines which use an inactivated toxin produced by the pathogen which they are targeted against to generate an immune response. In this way, the toxoid vaccine generates an immune response which is targeted against the toxin which is produced by the pathogen and causes disease, rather than a vaccine which is targeted against the pathogen itself. The whole cells or antigens will be depicted as either "DTwP" or "DTaP", where the lower-case "w" indicates whole-cell inactivated pertussis and the lower-case "a" stands for "acellular". In comparison to alternative vaccine types, such as live attenuated vaccines, the DTP vaccine does not contain the pathogen itself, but rather uses inactivated toxoid to generate an immune response; therefore, there is not a risk of use in populations that are immune compromised since there is not any known risk of causing the disease itself. As a result, the DTP vaccine is considered a safe vaccine to use in anyone and it generates a much more targeted immune response specific for the pathogen of interest. However, booster doses are recommended every ten years to maintain immune protection against these pathogens.

<span class="mw-page-title-main">Pulse Polio</span> Indian governmental immunisation campaign

Pulse Polio is an immunisation campaign established by the government of India to eliminate poliomyelitis (polio) in India by vaccinating all children under the age of five years against the polio virus. The project fights polio through a large-scale, pulse vaccination programme and monitoring for poliomyelitis cases.

<span class="mw-page-title-main">Contact immunity</span> Gaining immunity due to contact with a recently vaccinated person rather than from getting a vaccine

Contact immunity is the property of some vaccines, where a vaccinated individual can confer immunity upon unimmunized individuals through contact with bodily fluids or excrement. In other words, if person “A” has been vaccinated for virus X and person “B” has not, person “B” can receive immunity to virus X just by coming into contact with person “A”. The term was coined by Romanian physician Ioan Cantacuzino.

<span class="mw-page-title-main">Booster dose</span> Additional administration of vaccine

A booster dose is an extra administration of a vaccine after an earlier (primer) dose. After initial immunization, a booster provides a re-exposure to the immunizing antigen. It is intended to increase immunity against that antigen back to protective levels after memory against that antigen has declined through time. For example, tetanus shot boosters are often recommended every 10 years, by which point memory cells specific against tetanus lose their function or undergo apoptosis.

<span class="mw-page-title-main">Polio eradication</span> Effort to permanently eliminate all cases of poliomyelitis infection

Polio eradication, the permanent global cessation of circulation of the poliovirus and hence elimination of the poliomyelitis (polio) it causes, is the aim of a multinational public health effort begun in 1988, led by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF) and the Rotary Foundation. These organizations, along with the U.S. Centers for Disease Control and Prevention (CDC) and The Gates Foundation, have spearheaded the campaign through the Global Polio Eradication Initiative (GPEI). Successful eradication of infectious diseases has been achieved twice before, with smallpox in humans and rinderpest in ruminants.

The Expanded Program on Immunization(EPI) in the Philippines began in July 1979. And, in 1986, made a response to the Universal Child Immunization goal. The four major strategies include:

  1. sustaining high routine Full Immunized Child (FIC) coverage of at least 90% in all provinces and cities;
  2. sustaining the polio-free country for global certification;
  3. eliminating measles by 2008; and
  4. eliminating neonatal tetanus by 2008.

A vaccination policy is a health policy adopted in order to prevent the spread of infectious disease. These policies are generally put into place by State or local governments, but may also be set by private facilities, such as workplaces or schools. Many policies have been developed and implemented since vaccines were first made widely available.

Mass vaccination is a public policy effort to vaccinate a large number of people, possibly the entire population of the world or of a country or region, within a short period of time. This policy may be directed during a pandemic, when there is a localized outbreak or scare of a disease for which a vaccine exists, or when a new vaccine is invented.

DTaP-IPV-HepB vaccine is a combination vaccine whose generic name is diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B (recombinant) and inactivated polio vaccine or DTaP-IPV-Hep B. It protects against the infectious diseases diphtheria, tetanus, pertussis, poliomyelitis, and hepatitis B.

<span class="mw-page-title-main">Vaccine ingredients</span> Ingredients used in a vaccine dose

A vaccine dose contains many ingredients, very little of which is the active ingredient, the immunogen. A single dose may have merely nanograms of virus particles, or micrograms of bacterial polysaccharides. A vaccine injection, oral drops or nasal spray is mostly water. Other ingredients are added to boost the immune response, to ensure safety or help with storage, and a tiny amount of material is left-over from the manufacturing process. Very rarely, these materials can cause an allergic reaction in people who are very sensitive to them.

The COVID-19 vaccination program in the Philippines is an ongoing mass immunization campaign against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), in response to the ongoing pandemic in the country. The vaccination program was initiated by the Duterte administration on March 1, 2021, a day after the arrival of the country's first vaccine doses which were donated by the Chinese government.

<span class="mw-page-title-main">COVID-19 vaccination in Canada</span> COVID-19 vaccination programme in Canada

COVID-19 vaccination in Canada is an ongoing, intergovernmental effort coordinated between the bodies responsible in the Government of Canada to acquire and distribute vaccines to individual provincial and territorial governments who in turn administer authorized COVID-19 vaccines during the COVID-19 pandemic in Canada. Provinces have worked with local municipal governments, hospital systems, family doctors and independently owned pharmacies to aid in part, or in full with vaccination rollout. The vaccination effort in full is the largest such immunization effort in the nation's history. The vaccination effort began December 14, 2020, and is currently ongoing.

COVID-19 vaccination in Angola is an ongoing immunisation campaign against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), in response to the ongoing pandemic in the country. As of 15 June 2021, Angola has administered 1,314,375 doses of vaccines.822,109 people with the first dose and 492,266 people fully vaccinated. Angola began their vaccination program shortly after receiving their first shipment of Oxford AstraZeneca vaccine in early March 2021.

The National Advisory Committee on Immunization is an advisory body that provides the Government of Canada with medical and scientific advice relating to human immunization.

Vaccination in Mexico includes the use of vaccines in advancing public health. Mexico has a multi-year program for immunisation of children. The immunisation of children is fully covered by the government of Mexico. Mexico has an adverse events committee to monitor the adverse effects of vaccination as well as a standing technical advisory group on immunization.

<span class="mw-page-title-main">COVID-19 vaccination in Brazil</span> Plan to immunize against COVID-19

The COVID-19 vaccination campaign in Brazil is an ongoing mass immunization campaign for the COVID-19 pandemic in Brazil. It started on January 17, 2021, when the country had 210 thousand deaths.

Vaccine equity means ensuring that everyone in the world has equal access to vaccines. The importance of vaccine equity has been emphasized by researchers and public health experts during the COVID-19 pandemic but is relevant to other illnesses and vaccines as well. Historically, world-wide immunization campaigns have led to the eradication of smallpox and significantly reduced polio, measles, tuberculosis, diphtheria, whooping cough, and tetanus.

References

  1. "Monitoring vaccine wastage at country level : guidelines for programme managers". World Health Organization. 2005. hdl:10665/68463 . Retrieved 5 May 2021.
  2. "Quixplained: What is vaccine wastage, and how can it be prevented?". The Indian Express. 27 March 2021. Retrieved 5 June 2021.
  3. Wallace, Aaron S.; Krey, Kong; Hustedt, John; Burnett, Eleanor; Choun, Narin; Daniels, Danni; Watkins, Margaret L.; Soeung, Sann Chan; Duncan, Richard (16 July 2018). "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. doi:10.1016/j.vaccine.2018.06.009. ISSN   0264-410X. PMC   6032508 . PMID   29907485.
  4. 1 2 3 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 (25 April 2020). "Documentation of vaccine wastage in two different geographic contexts under the universal immunization program in India". BMC Public Health. 20 (1): 556. doi: 10.1186/s12889-020-08637-1 . ISSN   1471-2458. PMC   7183620 . PMID   32334554.
  5. Reagan, Nick (9 May 2021). "Clinics look to minimize vaccine wastage". WTOC. Retrieved 6 June 2021. 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. 1 2 "New York State COVID-19 Vaccination Program- Reporting Vaccine Wastage. COVID-19 Vaccine Wastage Reporting Guidance, Updated 2-15-21" (PDF). coronavirus.health.ny.gov. Retrieved 6 June 2021.
  7. 1 2 Young, Elise (22 April 2021). "Vaccine Waste at 0.1% Fails to Ease the Worries of U.S. Doctors" . Bloomberg. Retrieved 6 June 2021.
  8. Anderson, Maia (22 April 2021). "1 in 850 COVID-19 vaccine doses wasted in US, CDC data shows". Beckers Hospital Review. Retrieved 6 June 2021.
  9. Timsit, Annabelle (28 May 2021). "Covid-19 vaccine waste is about to go up in the US". Quartz. Retrieved 6 June 2021.
  10. World Health Organization Department of Immunization, Vaccines and Biologicals (30 September 2004). Immunization in Practice: A Practical Guide for Health Staff - 2004 Update. World Health Organization. pp. 31–32. ISBN   978-92-4-154651-5.
  11. Turp-Balazs, Craig (20 January 2021). "Emerging Europe's EU members will have a key role to play in distributing Covid-19 vaccines to their eastern neighbours". Emerging Europe. Retrieved 7 June 2021.
  12. Dhamodharan, Aswin (2011). Vaccine wastage reduction in immunization sessions through vaccine vial size optimization (Thesis). 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."