At a time when millions of Covid vaccine doses are needed to ramp up nationwide vaccination drive, I am shocked to find that Covid vaccine doses are being wasted in Rajasthan on a large scale. In my prime time show ‘Aaj Ki Baat’ on Thursday night, we showed how half-filled or partially-filled vaccine vials containing doses have been found thrown into waste bins of vaccination centres in Rajasthan.
Already, the Union Health Minister Dr Harsh Vardhan has told his Rajasthan counterpart to ensure that vaccine wastage is curbed immediately. He pointed to media reports of more than 500 vaccine vials found dumped in 35 Covid vaccination centres in eight districts of Rajasthan. The newspaper Bhaskar reported that many of the vials had 20 to 75 per cent doses filled inside, which could have been used for administering to as many as 2,500 people. The newspaper reported that there was 39 per cent wastage in Churu district, 29 per cent wastage in Hanumangarh, and 17 per cent each in Bharatpur and Kota districts. There was vaccine wastage in Boondi, Dausa, Ajmer and Jaipur districts too. At first, Rajasthan government was quick to deny wastage, but videos and pictures pointed to the contrary.
In Rajasthan, half-used vaccine vials were either thrown into waste bins, or buried 12 feet inside the earth or simply burnt, to remove all evidences of wastage. Our reporter Manish Bhattacharya went to Pali, 280 km from Jaipur. He found half-filled vaccine vials thrown into waste bins in Kot Khirana community centre. These vials were either half-filled or partially filled with vaccine doses which could have been given to beneficiaries. Inside one vial, nearly 80 percent vaccine doses were left, enough to inoculate 10 persons. Hardly 4 or 5 persons took the doses, and the remaining vial was thrown away.
I was shocked to see vaccine vials, half filled, being thrown away. At a time when millions of people find it difficult to register their names on CoWin portal, wait for days to get appointment slots, vaccines in Pali were being thrown into waste bins. At Raipur vaccination centre, the doctor told our reporter that any vaccine vial can be kept opened for four hours to administer doses to a maximum of 10 persons. At this centre, many vials, half -filled were being thrown into a ‘cold point’ box for eventual disposal.
As per standard protocol, after a session of vaccination is over, all the vials have to brought back to cold chain point. Whether the vial is empty, or half-full or partially full, it has to be returned. The used vials are then disposed of through autoclaving and microwaving. In autoclaving, the used vials are kept in hot water for 10 minutes, then kept in 1 per cent sodium hypochlorite solution for half an hour, and then all the vials are sent to a common treatment facility. If there is no such facility in a district, these vials are disposed of by throwing them securely inside a deep safety pit. Since there is no common treatment facility in Pali, used or half-used vials are sent to Jodhpur for treatment and disposal.
Our reporter found, many of the doctors and nurses looked not worried about vaccine wastage. In most of the centres, according to these health workers, they do not get sufficient number of people ready to take the dose, and because of this, the vials, after a gap of four hours, have to be discarded, even if they are partially filled. In total contrast was the situation in Jaisalmer, where the health team ensured that not a single dose was wasted. The doctors and nurses knew the worth of each drop of the dose. At some centres, they even used an extra dose found in the vials.
I would like to praise the district collector and the nurses, who took extra care to use every single dose. Vaccine management was the poorest in Pali, Churu, Hanumangarh and Kota, where several hundreds doses were wasted. At first the state health minister Raghu Sharma tried to do a cover-up, but after intervention from the Centre, Rajasthan chief minister Ashok Gehlot has promised to do a vaccine audit.
In UP’s capital Lucknow, our reporter Ruchi Kumar visited vaccination centres at Jiamau and Malhaur. Nurses and ANMs at these centres told her they open the vial only when at least five beneficiaries reach the centre. At 4 pm, when the vial is opened, they see to it that there must be 7 to 8 beneficiaries waiting. In Bihar, too, much care is taken to prevent vaccine wastage. At the Raxaul primary health centre, the vaccination in-charge said that they try their best to prevent wastage. Even after waiting for long, less than 10 beneficiaries appear, and some of the doses go waste. There were instances when people refused to wait for others to appear. They insisted that they should be given the jab immediately. At Mohali Phase 3 vaccination centre in Punjab, our reporter Puneet Parinja was told that health workers open the vial only when 10 beneficaries reach the centre. Date and time of opening the vial is written on the box, for easy handover to the next shift.
All these ground reports make anything clear: a little bit of intelligence is needed to prevent vaccine wastage. The wastage of vaccine that took place in Rajasthan is unacceptable. It should be considered no less than a crime, given the vast population that is waiting to get vaccinated. The best vaccine management was noticed in Kerala, where health workers administered doses to people more than the number they were supposed to, by carefully using the vaccine stored in the vials.
How did this happen? Actually, the manufacturers put more quantity inside the vials, apart from the required doses for 10 persons in one go. On average, one vial contains 11 doses, keeping a small margin for wastage. In Kerala, each drop of vaccine was used and every vial was used to give the jabs to 11 persons instead of ten. Within a time frame of four hours, if only 4 or 5 people appear for doses, the remaining vaccine gets wasted.
I will, therefore, appeal to all health workers including doctors and nurses, to ensure that not a single dose is wasted. In their hands, are the lives of millions of Indians, who need protection from the deadly virus. These vaccines are their ‘protection shields’ (suraksha kavach). The nation will forever remain grateful to these health workers if they prevent unnecessary waste of vaccines.
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