Due to the drop in demand for Covid-19 vaccines, Maharashtra’s net waste of Corbevax, India’s first indigenously developed RBD protein subunit vaccine, is 14.31 per cent — higher than the estimated allowable vaccine waste of 10 per cent. Corbevax was introduced on March 16. A total of 17 districts in the state have recorded net vaccine wastage above 15 per cent.
The most waste was in Parbhani at 31.14 per cent followed by Palghar (27.64 per cent), Amravati (25.55 per cent), Gondia (25.44 per cent) and Buldhana (22.67 per cent). Vaccine waste is broadly divided into two categories: waste in unopened vials and in opened vials.
In case of Corbevax, most of the waste is of opened vials where the remaining doses are discarded at the end of a vaccination session.
At the vaccination site, the waste of vaccines has a direct relationship with session size — the number of beneficiaries per session — and vial size. When The Indian Express spoke to the officers and doctors, they said the vaccination centres aren’t getting enough children to use the full 10 ml vial of Corbevax.
“A 10 ml vial of Corbevax is used to vaccinate 20 children. Once opened, the vial has to be used within four hours. But as Nandurbar is a tribal dominated district that is sparsely populated, gathering adequate number of children at the same place turns into the biggest hurdle to use all 20 doses,” said Dr Govind Chaudhari, district health officer, Nandurbar.
The centre has advised the states to mobilise people and not to open vials if they don’t have adequate number of people. “But it is not feasible to implement it as the children lose their patience and we can’t send them back,” said Dr Dayanand Suryawanshi, DHO, Palghar.
In fact, due to the drop in immunisation, a few districts that recorded among the lowest rates of vaccine waste in August, the ratio of waste surged gradually in October. For instance in August, Osmanabad reported net vaccine waste of 2.25 per cent and Aurangabad 3.34 per cent. In October, this increased to 6.45 per cent and 5.1 per cent respectively.
According to a health official from Amravati, since the monsoon onset in July, the situation has worsened as the travel time through hilly terrain has become more challenging. “Every village is separated by 4 km to 8 km. Earlier, the vaccinators could travel within stipulated time to use the remaining doses in neighbouring villages. But now due to the monsoon, the road has become inaccessible, making quick commute problematic,” he said.
But 15 districts in the state have recorded vaccine waste below the state’s average. This includes Bhandara, which is the only district that reported negative waste of Corbevax doses as vaccinators in the district were able to inoculate 21 beneficiaries from a 10 ml vial that is meant for 20 people. Dr Desai explained, “Sometimes, a vial has an excess dose called ‘overfill’. Then it is used to vaccinate the 11th person, which not only prevented waste but helped us achieve more than the set target per vial,” he said.
Dr SS Shelke, DHO of Aurangabad, told The Indian Express that the ‘captive vaccination policy’ was adopted by which vaccination camps were held in schools to get the most children at a time with the help of Asha workers and healthcare workers from Primary Health Centres (PHCs). “As the severity of infection among children is lower, not many come forward for vaccination. So, we held camps in schools that helped us attain our target and prevent waste of doses,” he said.
Vaccine waste is one of the key factors to be considered for vaccine forecasting and need estimation. The Union Health Ministry issued a circular in March 2021 with the formula about the number of Covid vaccine doses required in a month in a catchment area — Requirement = (Total population to be covered in the catchment area) × (% of the population to be covered in this catchment area/number of months of the campaign) × 2 doses × Wastage Multiple Factor (WMF).
However, the Centre hasn’t provided the figure about allowable waste percentage.The permissible vaccine waste rate varies according to the state and type of vaccines as per the norms of the central government.
Dr Sachin Desai, Maharashtra surveillance officer, said, “…the Centre has provided us with the allowable waste figure…”