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Hesitancy causes wastage of 1,000 vaccine doses in Delhi, say health officials

New Delhi: With the Covid-19 vaccination drive completing three days in Delhi, officials involved in the immunisation programme flagged another problem on Tuesday - that of wastage of doses
PUBLISHED ON JAN 19, 2021 11:54 PM IST

New Delhi: With the Covid-19 vaccination drive completing three days in Delhi, officials involved in the immunisation programme flagged another problem on Tuesday - that of wastage of doses.

Teams from a number of vaccination centres and health officials overseeing the city’s inoculation drive said at least 1,000 doses of the Covid-19 vaccines have been wasted in Delhi so far. Health officials attributed the wastage mostly to fewer people coming up to get the jab.

“As per the guidelines, vials of both Covishield or Covaxin have to be used and discarded within four hours of being opened. Each Covishield vial has 10 doses, and the low turnout is only adding to the wastage. If the hesitancy was not as high as it actually is now, then people would be queueing up and we could have grouped them in slots of 10 to reduce wastage,” said a senior health official.

Although Delhi government officials said it has not yet compiled data on the total number of doses discarded so far, health department officials said initial estimates indicate that on an average five doses are being wasted at the 81 vaccination centres each day.

At Guru Teg Bahadur (GTB) hospital, 9 doses were wasted on Day One, 6 on Day Two and 2 on Day Three. The Delhi State Cancer Institute discarded 14 doses in three days.

“Today (Tuesday), we had to open the third vial for just one beneficiary and the rest of the nine doses had to be discarded as no one else came by the end of the day. We have strict instruction from the government that no body can be turned away from the vaccination centres,” said Dr Pragya Shukla, the nodal officer at Delhi State Cancer Institute (DSCI).

But, Dr Ravinder Pal Dhingra of Chacha Nehru Bal Chikitsalaya, another vaccination centre, described it as “a number game”.

“Even if the turnout is as high as 91 at a centre, still 9 doses would go waste on that day. It’s mostly a game of numbers. But it is true that if more people were willing then we could have scheduled 9 more people for the day and shifted the remaining ones to the next day. At our hospital, we have vaccinated around 39, 49 and 55 people in the past three days,” said Dhingra.

A senior doctor from Delhi government’s Rajiv Gandhi Super Speciality hospital said the government anyway already considers that 10% of the total stock of doses would go in vain either through wastage or breakage.

“However, to ensure that not too many doses go waste, after about mid-day we wait for a few people to come in before opening any new vials,” said the doctor.

To ensure fewer doses are wasted each day, many centres started walk-in vaccination from Tuesday. While Ram Manohar Lohia hospital and Lady Hardinge Medical Colleges allowed this from Monday, several others such as DSCI and GTB hospital started it from Tuesday.

“Today, 24 healthcare workers got the jabs at our centre as per the list generated by the Co-WIN app. But, by 4pm our district administration allowed us to vaccinate even those healthcare workers who are not in the list but are registered and verified in the Co-WIN app. So, to ensure minimum wastage of doses, I took the shot and so did two additional medical superintendents and one senior doctor of the hospital. So, only one dose was discarded today,” said Dr Sweta, the nodal officer of the vaccination programme in GTB hospital.

A senior official from the Ministry of health and family welfare said the shelf life of unopened vials of both Covishield and Covaxin is six months from the date of manufacturing. “Irrespective of which vaccine is being used, every vial, once opened has to be used within four hours at a temperature between 2 and 25 degrees Celsius. Open vial policy has not been allowed in India yet,” said the ministry official on condition of anonymity.

With 75 of the 81 centres giving Covishield jabs, Delhi primarily is using these doses over the Covaxin doses which is being used in only six centres. While each vial of Covishield has 5ml of the vaccine with each dose being 0.5 ml, which is equivalent to 10 doses, a Covaxin vial contains 20 doses.

Dr T Jacob John, former head of the department of virology at Christian Medical College, Vellore, said the government should consider increasing the duration of usage of each opened vial of Covishield vaccine from the existing 4 hours to 6 hours.

“Serum Institute of India which manufactures the Covishield vaccine says an opened vial can be used up to a maximum of 6 hours. The government should allow centres which are able to maintain the desired room temperatures to use vials up to 6 hours instead of 4,” he said

John suggested that the open vial policy can still be considered for Covaxin, but stated the same can never be possible for Covishield.

“Reusing the vial is called open vial policy. Covishield vaccine contains live virus because of which no preservative can be added to it. Therefore, an open vial policy cannot be allowed. But, Covaxin does not contain any live virus and it has a preservative called 2-phenoxyethanol. Therefore, the government should declare an open vial policy for Covaxin at least. This will ensure reduction in wastage,” he said.

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