POST 00473E : VACCINE WASTAGE

POST 00473E : VACCINE WASTAGE Follow up on Posts 00311, 00316, 00320, 00324, 00345, 00349, 00404E and 00462E 11 July 2002 ______________________________________________________________________ Dr. Sobhan Sarkar (mailto:[log in to unmask]) from the Department of Family Welfare of India and Mr. Elly Tumwine Rweizire (mailto:[log in to unmask]) from EPI Uganda are both making a contribution to the discussion on vaccine wastage ______________________________________________________________________ The issue of vaccine wastage needs to be looked at on the basis of micro-planning. Currently available vaccines are in multi-dose vials. Worst is that of BCG which is 20 dose ampules or vial. In an outreach session there may not be more than 3-4 children for BCG vaccination resulting in high wastage rate. Each outreach session has to be given at least one vial of each antigen or multiple vials and thus there would be high wastage. Say for 12 doses of DPT we would need to issue 2 vials of 10 doses resulting in wastage of 8 doses i.e. 4 doses per 10 doses. Therefore, before we take a stand we need to look at the specific situation. S. Sarkar ___________________________________________________________ TACKLING THE "MONSTER" VACCINE WASTAGE. The burning question "how to reduce vaccine wastage?" is still relevant. Tracking vaccine wastage is in its infancy stages in Uganda. The rates on paper are still debatable. But we have started the process to get to actual numbers. I quite agree with Bob Davis that calculating vaccine wastage annually on a national basis is a "post mortem" and too late to take corrective measures. Unfortunately that's what many of us have done for a long time. The health worker at unit level appreciates the need to track vaccine wastage where it has been explained but there is still inadequate commitment to put the results on paper. Some still believe it is a tool that will be used to monitor their performance. (Would high vaccine wastage not be taken for not doing a good job?). The issues that I want bring forward are as follows: · MDVP one of the most recently introduced concepts on management of vaccine wastage, has now been reduced to OPV and TT (for us who used OPV, TT, BCG, Measles and DPT), as we have gone into DPT-HepB+Hib with dry freeze Hib and therefore DPT falls off. · While it is true that the 2-dose vial should register a very small vaccine wastage (5% as suggested), tackling reduction of Drop-Out Rate and missed opportunities has warranted increased session frequency. This tremendously reduces session size and chances of wasting one dose per session cannot be ruled out. We are yet to establish what the actual wastage will be for DPT-HepB+Hib. However it is still enormous for Measles (10 dose vials) and BCG (20 dose vials). It is still a long way to dream of running away from outreach session strategy. This still accounts for more that 40% of expected coverage in our country. This also does not favour MDVP under the circumstance where guaranteeing non-contamination plays a main role. We have tried to move the service delivery points closer to community. But the closer we move, the more it appears that we are not near enough, resulting in a drop in coverage. Thanks for the formulae for vaccine wastage. These will be helpful in our tracking process. Elly ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- CONTRIBUTIONS: Contributions to: or use your reply button! The TechNet21 e-Forum welcomes new subscribers who are involved in immunization services. SUBCRIBE: To subscribe, send an e-mail to: Leave the SUBJECT area BLANK, do not type anything. 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