Wellington Dufferin Guelph Public Health (WDGPH) wasted 8.4 per cent of vaccines in 2022, a dollar value of $481,191.
This is an increase of 4.1 per cent from 2021. The Ministry of Health did suspend vaccine returns but it resumed nearing the end of 2021, into 2022.
These aren’t just COVID vaccines but flu, and routine childhood vaccines, among others.
“Additionally, access to healthcare providers in 2021 were limited, again, due to the pandemic and therefore vaccines already in healthcare fridges expired before being utilized. These two factors contribute greatly to the significant increase in vaccine wastage in 2022,” detailed in the 2022 vaccine wastage report by WDGPH.
These factors increase vaccine wastage and skews the data. There should be less of a discrepancy for 2023, since the data should meet the Ministry of Health threshold of wastage for any specific single vaccine greater than five per cent.
“But the problem is, is that the way they calculated is they used how much vaccine we distributed, and then how much we received. So it's a huge discrepancy. Almost every year, it's a huge discrepancy,” said Rita Isley, director of community health and chief nursing officer for WDGPH.
“It skewed our vaccine wastage because it was almost two years of vaccine we were accepting back,” she said.
This is during the time period of 2021 and 2022.
The value of vaccines wasted in 2020 was $40,381 and in 2021 was $151,999.
“Because we have … publicly funded vaccines. So essentially, all public dollars, all of our taxes and everything go to paying for these vaccines. And so when they get wasted, we're wasting public dollars,” said Isley.
Once vaccines are distributed to physicians, and clinics the vaccines can’t be returned and redistributed.
“The greatest risk for vaccine wastage is short-dated vaccine as well healthcare providers ordering excess quantities or stockpiling vaccine,” said the report.
The rule of thumb is, vaccines shouldn’t be ordered or stored for longer than a two week period, said Isley.
“Excess product ordering by community partners is difficult to control without adversely affecting client service and immunization coverage rates,” continued in the report.
Other factors are excessive quantity of vaccines that excludes COVID vaccines, refrigeration or equipment malfunction, unused pre-drawn syringes, expired product, count discrepancy, and suspected vaccine contamination.
The laundry list of reasons why COVID vaccines were wasted are;
- Damaged product
- Defective product
- Doses remaining in punctured vial beyond 24 hours
- Stored in refrigerated temperatures beyond 30 days
- Doses remaining from a single or multi-dose vial
- Vial left at room temperature beyond 12 hours
- Vial left at room temperature beyond 24 hours
- Suspected vial contamination
- Unused pre-drawn syringe
- Full dose syringe used to administer half dose
- Vaccine administration issue
- Vaccine ancillary supply issue causing vaccine wastage
COVID mRNA vaccines like Pfizer or Moderna, have a shorter shelf life than other vaccines. When the multi-dose vials are punctured, vaccine administrators have a matter of hours before it expires. Pfizer is a multi-dose vial with 10 doses and Moderna has six doses.
“So in public health clinics, our mass clinic, we do our best to try and conserve the vaccine as best we can,” said Isley. They have the ability to do this because they can count how many people will be receiving the vaccine.
Where the vaccine wastage issue lies is in a primary care office where a multi-dose vial is punctured, maybe one person received a dose, when 10 people could have received a dose from the same vial.
“For particularly the vaccine hesitant population, if they see their primary care provider and their primary care provider is able to work with them to accept getting the vaccine. We would rather them waste the doses and vaccinate someone that's at risk and now willing to accept the vaccine,” said Isley.
Because the alternative would be if they chose not to get vaccinated they could contract COVID and may have complications, she said.
To limit vaccine wastage, refrigeration inspections are completed, and education around vaccine safety, storage and handling is provided.
Weather also plays a factor on vaccine wastage, because if there is a storm and it impacts electricity, fridges storing vaccines would then be spoiled.
“If we're anticipating a significant storm that could result in losing our power, we will take vaccines from the community and store it in our fridges that are backup generators for the duration of the forecast of bad weather, and then people can come back and pick up their vaccines and take it back to their offices,” said Isley.
When people get a vaccine, it is a safe vaccine, she said. “We're working to manage it fiscally responsibly because it is public dollars.”
