At least 10 per cent of Covid-19 vaccines procured by the Centre may face "programmatic wastage", according to the vaccination plan guidelines released by the Ministry of Health and Family Affairs Ministry. This means nearly 10 in every 100 vaccines the Centre will buy from approved vaccine makers such as Serum Institute & Bharat Biotech may suffer damage in different phases of vaccine management. Also, the Centre will have to order 110 vaccines to vaccinate 50 people, considering a two-dose regime and 10 per cent "wastage". The wastage of vaccines, despite limited stock available initially, is bound to hamper vaccination progress and also put an additional financial burden on the government.
The initial 30 crore vaccinations (60 crore doses) planned by the Centre (@Rs 440 per person for 2 doses) would have cost Rs 13,200 crore. However, need for 66 crore doses to account for wastage raises the cost by Rs 1,320 crore, taking the total bill to Rs 14,520 crore in the first phase. The Centre says the total COVID-19 vaccines required for 1 month will depend on population to be covered in an area, percentage of people getting vaccines in each phase, two-dose regimen, and wastage multiplication factor (WMF), which is 10 percent.
"WMF = Wastage Multiplication Factor = 1.11 for the COVID-19 vaccine, assuming an allowable programmatic wastage of 10% [WMF = 100/ (100 - wastage) = 100/ (100-10) = 100/90 = 1.11)," the guidelines suggest.
As of now, there are four companies that are in different stages of clinical trials, with Serum Institute of India ahead by a few months, followed by Bharat BioTech, Russia's Sputnik V Vaccine and ZyCovid from Zydus Cadila. SII and Bharat Biotech have received emergency approval to roll out their vaccines under Emergency Use Authorisation which where only the government will buy vaccines.
The vaccine developed by Oxford University and Swedish pharma major AstraZeneca and manufactured by Serum Institute has shown efficacy ranging from 62 pc to 90 pc under different conditions. Bharat BioTech is still conducting Phase 3 clinical trials.
Serum chief executive Adar Poonawalla says each vaccine vial will cost the government around Rs 220 ($3). Two doses required to generate antibodies will cost around Rs 440 per person.
The Centre plans to launch what PM Modi described as "the world's biggest vaccination programme" in the next one-two weeks. Over 30 crore people from priority groups will be vaccinated first. These 30 crore Indians come from three groups - 1 crore healthcare providers, 2 crore frontline workers and 27 crore people over 50 and under 50 with co-morbidities.
How govt plans to limit wastage
With the limited vaccine availability in the initial phases, adequate security arrangements need to be in place for safety of vaccine at storage site, during transportation and at session site. To ensure every COVID-19 vaccine vial reaches up to the last mile, the ministry's Co-WIN system will have all details -- name of vaccine, batch, manufacturing date. This electronic database will ensure end-to-end tracking of all vaccines. Vaccine doses along with batch number will be allocated to each site via Co-WIN system only.
Vaccine vials may not have labels indicating 'government supply' in the initial phases but officials will have to ensure stringent track-and-trace mechanism. Once the stock is released, the government officials will first physically count all vaccine vials. All data about incoming/outgoing stock will be fed to Co-WIN. In case of mismatch, the state immunisation officer will have to be informed.
Any damage or breakage of over 10 vials will be examined by a medical officer in-charge. The official will physically examine, count, photograph and certify and ascertain the reason behind the damage. The data on breakage will be then fed to the Co-WIN system.
The supply store in-charge will be accountable for damage to vials during transportation. It'll also ensure proper packing and stacking of cold boxes in vaccine vans to prevent damage. The cold chain point in-charge will have to ensure safe disposal of unusable or empty vaccine vials as per the Central Pollution Control Board (CPCB) rules.
For minimal damage and safety of vaccines, state and district authorities will have to ensure 24*7 security of cold chain points with restricted access to authorised persons only. All vehicles will be sealed before leaving the cold chain point till they reach the facility in-charge.