What is an acceptable wastage level?

As the local situations and experiences vary, it is impossible to determine globally acceptable vaccine wastage levels. Vaccine wastage rates are higher in rural areas as they have to open more vials in remote services. In such cases, to achieve higher immunization coverage, a higher wastage rate has to be accepted.

In our last article, we have seen the reasons why vaccines go to waste. In this article, we will see how we can minimize the vaccine wastage rate. There are few ways in which we can do this –

1. Preventing Freezing: Vaccines can freeze during transportation or storage if exposed to freezing temperatures. To prevent this from happening, you can take the following steps –

Make sure shelving units are not close to the evaporator where there is cold air. Fit the evaporator with a cage so that vaccines are stored somewhere else but near the evaporator.

Make sure to face ceiling-mounted evaporators away from shelving units. Do not position them directly above the shelving units. Instead, keep them at the center of circulation aisles. If you have to mount the evaporators above the shelving units, please keep a distance of at least 75cm between them.

2. Monitoring vaccine wastage at sentinel sites: Sentinel sites can monitor vaccine wastage rates and compile reports about the same. And then send them to the national immunization program monthly.

3. Temperature monitoring: Vaccines arrive in the national cold store, where they are stored and distributed in bulk. That is why it is crucial in managing vaccine wastage.

It is possible to lose a large number of vaccines due to poor management and equipment failure. Managing vaccine wastage levels at such an initial stage can reduce the risk and financial loss that a country might experience.

4. The vaccine wastage rate is high for multi-dose vials, in case not fully utilized within four weeks after opening them. To avoid it, you can keep subsequent sessions over four weeks. This way, the number of vaccines discarded at the end of the session will be less.

5. Rather than keeping a small session size, go for a big session size to reduce wastage of the vaccine.

6. The number of doses per vial changes according to vial size. Changing the vial size can be helpful to avoid wastage.

7. Many wealthy countries have an excess number of vaccines. Thus, detailed forecasting about vaccine requirements is essential.

8. Do not keep frozen, expired, damaged vials in the refrigerator or freezer, as they may get mixed with usable vials resulting in wastage.

If you have to keep them for accounting or auditing purposes before disposal, it is better to keep them outside the cold chain. And put ‘Do not use -Expired/ damaged vaccine’ label on them. Record only usable vaccines in the stock.

As discussed above, planning session size, forecasting is necessary for managing vaccine wastage. These are the way to increase immunization coverage when the vaccines are scarce.

Thank you for reading the article. Stay tuned for the next one. 😊

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