States on overdrive to reduce vaccine wastage as Covid-19 cases rise

Experts say controlling spoilage with 10-dose vials may give vax drive a shot in the arm

As India witnesses a ‘second wave’ of the Covid-19 pandemic, the demand for vaccination has increased manifold. Hence, every step is being taken to reduce vaccine wastage.

For example, the number of doses in a pack of Covaxin has been halved — from a 20-dose pack, Bharat Biotech’s vaccine now contains 10 doses.

Covishield, manufactured by the Serum Institute of India, also comes in 10-dose packs.

A United Nations International Children’s Emergency Fund (UNICEF) study on vaccine spoilage in 2009-10 said that wastage was least when the vial had five doses.

Vaccine doses can be wasted for various reasons — in opened vials as well as unopened ones. When the doses are not used within four hours or so after opening the vial, they are wasted.

Currently, India’s Covid vaccine wastage rate is 6.5 per cent, which is much lower than the wastage rate of vaccines that are part of the national immunisation mission.

An UNICEF study across five Indian states revealed that, in general, the wastage rate ranged “between 27 per cent and 61 per cent for various vaccines”.

The World Health Organization estimates that about 50 per cent of the vaccines produced globally is wasted.

Professor Dileep Mavalankar, director, Indian Institute of Public Health Gandhinagar, says that in some cases, such as the BCG (or Bacille Calmette-Guerin) vaccine, the wastage is high since the government stipulates that the vaccinator should open a vial, even if there is only one child to be immunised.

“But this is a pandemic. So the effort should be to reduce this 6.5-per cent vaccine wastage to zero,” he adds. 

Mavalankar says this can be done by drawing up a waiting list of people in the community (any age group) exposed to multiple contacts. “If there is chance of doses going to waste, we can call these people and vaccinate them,” he suggests. 

Smaller vials, bigger reach

States are taking several steps to minimise vaccine wastage.

For example, state health department officials in Gujarat said that reducing the number of doses in a vial of Covaxin has been of great help. 

“If 13-15 people turned up for vaccination, the rest of the doses were wasted. But now Covaxin packs have 10 doses each, instead of 20, to reduce wastage,” says a senior health department official.

To curb wastage in rural areas, local authorities have been asked to mobilise people for vaccination.

“If eight or nine people turn up for inoculation, they won’t be turned away for want of one person. Instead, the centres have been asked to mobilise people for vaccination. Bigger centres in Gujarat have not seen so much of wastage as vials get used quickly,” the official stated, adding the state has not seen any vaccine wastage on account of cold chain failure so far.

Among states, Tamil Nadu has one of the lowest vaccine wastage rates —  3.7 per cent.

In the neighbouring states of Telangana, Andhra Pradesh, and Karnataka, the wastage is 17.6 per cent, 11.6 per cent, and 6.9 per cent, respectively. 

In Maharashtra, Chief Minister Uddhav Thackeray has directed district collectors to bring down vaccine wastage to zero. While the state has an average wastage of 5.2 per cent, some districts have fared worse. Pune, for example, has an 8-per cent wastage rate.

“With the summer months approaching, we have asked the districts to conduct vaccinations pre-lunch and then resume in the evenings.”

The state feels this would lessen wastage as booths usually go empty in the afternoon. 

Wanted: More jabs

The demand for Covid vaccines has also risen in the latest phase of the vaccination drive.

In Gujarat, 2,500 vaccination centres are operational now, up from just 600-700 in the beginning of March. Gujarat received an additional allotment of 1.35 million doses on Friday to take up the current stock to 3 million doses. The state is aiming to administer 300,000 doses daily and has a 10-day stock in its kitty.

Maharashtra, too, has a stock of around 3.1 million doses of vaccines.

In Tamil Nadu, the number of jabs being administered was over 100,000 in the last three days, compared to around 10,000 at the outset.  

To ramp up its vaccination drive, Tamil Nadu is opening up around 2,000 new mini clinics and primary health centres. The shots are being provided in 3,400 places, including 761 private hospitals. The state government plans to increase the number of private hospitals and also reel in organisations, such as the Rotary Club, that have experience in vaccinations, say state health department sources.