POST 00681E : VACCINE WASTAGE

POST 00681E : VACCINE WASTAGE Follow-up on Post 00620E and all postings on Vaccine Forecast 28 May 2004 ________________________________ Ãœmit Kartoglu (mailto:[email protected]) from WHO clarifies some points on vaccine wastage in relation with the document he authored on the subject and comments from the discussion on vaccine forecast. ________________________________ Being the author of the mentioned "monitoring vaccine wastage at country level: Guidelines for programme managers (WHO/V&B/03.18)" I would like to make the following comments on the discussion: 1. The above mentioned manual is not a job aid that gives prescribed action points. It is designed in a way that discusses vaccine wastage in detail to provide a comprehensive information on reasons and approaches to reduce or eliminate it. It also explains simple and advanced vaccine wastage calculations and proposes a sentinel site surveillance for monitoring of vaccine wastage at the country level. Section 8 (pages 43 to 45) is the summary that can be referred for easy reference. The manual brings the following new points that were never considered before in wastage calculations: - Vaccine wastage at store levels - Concept of wastage in opened and unopened vials. - Calculation of wastage factor as a multiplication factor of wastage rates calculated both from the field and vaccine stores - Analyzing vaccine wastage rates against immunization performance. - Sentinel site vaccine wastage surveillance. 2. "Vaccine usage rate" has more positive spin compared to vaccine wastage. In general "wastage" as a concept is not appreciated by many and especially by politicians. It would be critical in many settings to speak with the usage rates. 3. Of course, the easiest way to calculate vaccine wastage factor is dividing the number of doses used by the number of doses administered. But this formula does NOT take into account the number of doses wasted at the storage facilities and during in-country transport. Experience shows that vaccine wastage at storage facilities is high and should NOT be ignored. In addition, calculating "number of doses used" is not an easy task if you are receiving reports from each and every immunization facility in your country. Number of doses used includes doses used for immunization and all doses discarded or lost for any reason (including expiry, VVM indication, cold chain failure, freezing, missing inventory or routine discard of open vials of vaccine at the end of a session). To do this each immunization point should report on their start balance, number of doses received and end balance so number of doses used can be calculated easily (which is not the case in many countries). 4. Oleg is right, if number of doses administered corresponds only to DTP3, all doses given as DTP1 and DTP2 will be counted as "wasted". If all doses given are not included in the formula, the country may end up ordering unnecessarily high number of doses. This is clearly described in the above mentioned manual (see page 16 footnote 11). 5. Unless wastage is studied in detail as described in the manual, measures to reduce or eliminate it cannot be introduced. With the usual formulas as indicated in previous postings, the country can only have a wastage factor for the sake of inclusion in vaccine forecast. This vaccine wastage factor will not be sufficient to decide what measures should be introduced to reduce the wastage. The manual was prepared in order to assist countries to reduce wastage. Thanks and cheers, Umit Kartoglu ______________________________________________________________________________ Visit the TECHNET21 Website at http://www.technet21.org You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : mailto:[email protected] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de coopération internationale en santé et développement, Québec, Canada (http://www.ccisd.org) ______________________________________________________________________________