Findings of a new study by researchers at Makerere University School of Public Health shows high levels of vaccine wastage in both rural and urban health facilities in Uganda.
The research was conducted in Mukono and Kalungu districts where the scientists assessed wastage rates of six essential vaccines: BCG against tuberculosis, Oral Polio Vaccine (OPV), Injectable Polio Vaccine (IPV), pneumococcal vaccine (PCV), Measles –Rubella (MR) and DPT–HepB–Hib.
Findings published in the Global Public Health journal show that vaccine wastage rates were far above national and WHO-recommended threshold whereby BCG wastage stood at 70%, MR at 58%, IPV at 31%, OPV (28%) and PCV (17%).
General guidelines for Vaccine Wastage Rates (VWR) recommend different acceptable rates for different vaccines that is 50% for BCG and 25% for reconstituted measles vaccine, 10% for OPV, 15% for liquid vaccines in multi-dose vials containing 10 or more doses, and 5% for liquid vaccines in single or two-dose vials like PCV.
Apart from measuring wastage using data collected from 22 health facilities, the researchers, led by Dr. Simon Kasasa, a Senior Lecturer in the Department of Epidemiology & Biostatistics, also surveyed 57 health workers and conducted key informant discussions.
In these interviews, they found reasons for vaccine wastage to include use of large multi-dose vials, low turnout during community outreaches, cold chain failures, poor documentation, and limited staff training.
According to estimates by the Ministry of Health, Uganda vaccination coverage is commendable with many of vaccines having coverage higher than 80%. Vaccines such as DPT, BCG and Pneumococcal Conjugate vaccine (PCV3) have even higher accessibility estimated at over 90%.
Now, to reduce wastage, study authors recommend improved planning through predictive models, reduced-volume vaccine vials, decentralized immunization approaches, and refresher training for health workers in vaccine handling and data management. These interventions, they argue, are essential to reducing wastage and improving efficiency in Uganda’s immunization programme.
Uganda’s routine immunisation schedule starts at birth with BCG and OPV vaccines. At 6, 10, and 14 weeks, children receive OPV, IPV, Rotavirus, DTP-HepB-Hib, and PCV vaccines. At 9 and 18 months, they receive the Measles-Rubella vaccine.
Most vaccines, including BCG, OPV, IPV, Rotavirus, DTP-HepB-Hib, and Measles-Rubella, are supplied in multi-dose vials, while PCV is administered using single-dose vials.