Post 00413e : Vaccine Wastage (study)

POST : 00413E : VACCINE WASTAGE (STUDY) 18 January 2002 _________________________________________________________ The journal "Vaccine", in its issue no.20 (2002) published an article :"Frequency and Causes of Vaccine Wastage", a study of vaccine wastage in the United States. It was brought to our attention by one of the authors, Bruce Weniger [[log in to unmask]" eudora="autourl">mailto:[log in to unmask]] from the Centers for Disease Control and Prevention. Conditions of immunization programmes in the United States may make any comparison with data from developing countries difficult. However, as you will read in the section "Results" of the abstract reproduced below in the body of the text, the main causes of wastage seem "déjà -vu", refrigeration (cold chain) lapses and expiration. Please also note the interesting conclusion in the abstract that "the two most common forms of wastage reveal the potential value of developing vaccines with improved heat stability and longer shelf lives". The full article is attached herewith. All subscribers should at least take the time to read the full text of the discussion which contains a number of paragraphs discussing wastage in the developing world. The text can also be found at the following URL : http://www.elsevier.com/locate/vaccine This site requires registration for downloading but it is free. ________________________________________________ Abstract Assessing the frequency of vaccine wastage and the relative magnitude of its various causes may help to target efforts to reduce these losses and to husband funds for increasingly expensive vaccines. Methods: As a preliminary overview of wastage in the United States, 64 public-sector state and local health department immunization programs were polled in 1998 and 1999 for wastage recording practices. Actual wastage data were collected from a non-random subset of five states. Data on returns of wasted vaccine to manufacturers were analyzed from routine national biologics surveillance and from an ad-hoc survey. Excise tax credit requests for such returns between 1994 and 1999 were reviewed. Results: Rates of wastage among the five states ranged from about 1 to 5% in 1998, with an overall rate of 2.6% among 57 immunization programs in 1999. Categories of wastage used by the health departments varied widely, with overlapping classifications. The major causes appeared to be refrigeration (cold chain) lapses, followed by expiration. Overall rates of vaccine returns varied up to 8% by manufacturer, and from 1 to 50% by vaccine type, with higher return rates generally found for lesser-used vaccines. Conclusions: If these wastage estimates of 1–5% applied nationally, in 1998 there would have been approximately US$ 6–31 million worth of unused vaccine in the public sector alone. The two most common forms of wastage reveal the potential value of developing vaccines with improved heat stability and longer shelf lives. We propose six main classifications of vaccine wastage for use in routine monitoring and reporting. Published by Elsevier Science Ltd. Keywords: Wastage; cold chain; Expiration _____________________________________ ##text##