The Public Health Foundation (PHF) has been hearing concerns about wasted vaccine from those who are and will be responsible for COVID-19 vaccinations. In response, PHF has engaged in a quality improvement (QI) initiative to help those receiving the COVID-19 vaccine reduce potential wasted vaccine. Some waste is unavoidable in any large-scale immunization program. A study completed in 1998 showed rates of wastage as 1% to 5%, with an overall rate of 2.6% among 57 immunization programs.ⁱ Even small percentages like these can equate into millions of lost doses of COVID-19 vaccine.

To assist in identifying various causes of vaccine waste and potential countermeasures to reduce their occurrence, PHF developed the Process Decision Program Chart (PDPC)ⁱⁱ for COVID-19 Vaccine Waste. When accessing this document, please add what you are experiencing or foresee as potential causes of vaccine waste and countermeasures.

PDPC is best used when the risk of failure for a project is high or there is a very tight implementation timeline, and the implementation team needs to think through what could go wrong with an implementation plan and how to prevent those failures.  

PDPC is a tool to that can be used to help systematically identify what might go wrong in a COVID-19 vaccination implementation plan and to rank those factors that might go wrong. Then, the organization can focus on the most likely factors and build in countermeasures to the implementation plan to prevent or offset those potential problems. PDPC is a form of “Fool Proofing” a solution. Using PDPC, an implementation team can either revise the plan to avoid the problems or be ready with the best response when a problem occurs.

Most vaccine providers should have well-defined and clearly written Standard Operating Procedures (SOP) in place. The SOP should start with the placing of the vaccine order all the way through administration of the vaccine. These procedures should be continuously updated, based on experiences with the COVID-19 vaccines. The Process Decision Program Chart for COVID-19 Vaccine Waste can be a useful tool in helping to update SOPs and reduce vaccine waste.

It is important for a COVID-19 vaccination implementation plan to address ways to limit wasted vaccine. PHF hopes that the Process Decision Program Chart for COVID-19 Vaccine Waste​ will be helpful in developing preventive measures to avoid or limit waste, planning for contingencies, and implementing contingencies should problems occur​.

Please contact Jack Moran, PHF Senior Quality Advisor, [email protected]​, with any questions or suggestions you have about using the Process Decision Program Chart for COVID-19 Vaccine Waste.​​

You can calculate your vaccine waste using the following formulasⁱⁱⁱ as you roll out your vaccine implementation plan:

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ii. Public Health Quality Improvement Encyclopedia, J. Moran, et al., Public Health Foundation, 2012, pp: 97-98

iii. Vaccine wastage in Bangladesh​. S. Guichard, et al., Vaccine, 2010 Jan 8, 28(3), pp: 858-863.