Providers urged to help cut wastage
Immunisation providers are being urged to help reduce vaccine wastage by considering the high costs of vaccines when storing and stocking up on vaccines provided free under the National Immunisation Program (NIP).
The WA Department of Health (DoH) is concerned that some providers may be unaware of the costs of individual vaccines, which are significant when the vaccines routinely stored in a practice refrigerator are added up.
A single .5ml dose of Gardasil for example—used in the prevention of human papilloma virus (HPV)—costs around $100 and girls require three doses to be fully protected against the most common strains of HPV. Similarly, Infanrix Hexa, given to children at 2, 4 and 6 months of age, is priced around $65 a dose.
To help reduce vaccine wastage the DoH is encouraging providers to:
- consider existing stock and their practice’s demand for immunisation when reordering vaccines, reducing the risk of vaccines reaching their expiry dates without being used
- avoid overstocking fridges. Overstocking can reduce airflow, placing a strain on fridges that can lead to fridge malfunction and cold chain breaches
- check fridges regularly to ensure vaccines are being stored within the recommended 2–8 °C temperature range.
The WA Department of Health receives approximately $33 million worth of vaccines each year to immunise children against a wide range of diseases including; hepatitis B, pneumococcal, rotavirus, diphtheria, tetanus, pertussis, poliomyelitis, hemophilus influenzae type B, meningococcal C, measles, mumps, rubella, varicella (chickenpox) and hepatitis A.
The vaccines are used according to the National Immunisation Program schedule and supplied to the Department by the Commonwealth under the National Partnership Agreement for Essential Vaccines (NPAEV).
The WA Department of Health is accountable for all vaccines bought via the Commonwealth and reports quarterly on vaccine usage and wastage.
Each year significant amounts of vaccines are discarded in Western Australia due to cold chain breaches whereby the vaccine is exposed to temperatures outside the recommended 2-8 °C. These breaches occur primarily through power outages or refrigerator failure.
Providers are required to report all vaccine loss to their local Public Health Unit—regardless of whether such loss is as a result of refrigerator failure, power failure, cold chain breaches, breakage or vaccines passing their use-by dates.
In the event of a cold chain breach providers should:
- mark the vaccines ‘do not use’
- isolate them in an alternative 2–8 °C environment
- contact their local public health unit.
Providers should not dispose of any vaccines until their viability has been discussed with the regional immunisation coordinator.
For a more in-depth look at vaccine efficacy and cold chain breach protocols, please refer to the article on ‘Protecting vaccine potency’ in the October 2011 edition of DiseaseWAtch.
Simple system for ordering online
Ordering vaccines available under the National Immunisation Program schedule is a simple process.
Immunisation providers across the metropolitan area can order NIP-funded vaccines via the online vaccine ordering website. The website is accessed using a unique username and password, both of which are issued by the Communicable Disease Control Directorate.
Practices or clinics that do not already have access to the online ordering system should email the vaccine team or telephone 9388 4835. Those without internet access can fax vaccine orders to CDCD on 9388 4877. Orders placed by fax may take an additional 24 hours to process.
Providers in the Wheatbelt and Goldfields came online recently. The roll out of the online ordering system across regional WA is expected to be completed within the next few months. Regional providers not yet using the online system should order vaccines through their Regional Pharmacy.
Using the system
The process of ordering vaccines online is simple and efficient and orders can be placed weekly.
Most vaccines are available in single doses or packs of 10. Some vaccines have maximum limits (eg Year 7 vaccines are limited to 5 vaccines per order). Most, however, are not limited.
Once an order is placed:
- a 10-digit purchase order number will be generated. This number should be recorded and quoted in any subsequent communications regarding the order, including vaccine delivery
- the order will be viewed and approved by CDCD staff
- approved orders will be sent to the CSL warehouse, the contracted state distribution centre
- CSL will collect, pack and ship the vaccines to metropolitan immunisation providers and to the state’s eight Regional Pharmacies, which act as regional distribution centres.
The current turn around time for deliveries in the metropolitan area is 3 to 4 business days. Regional deliveries take longer because vaccines are repackaged and forwarded on from regional distribution centres.
An instruction manual can be accessed from the ordering site.
The WA Department of Health oversees the on-line ordering system and approves all vaccine orders. CSL is contracted by the Department of Health to pack and deliver the vaccines. Queries relating to vaccine delivery should therefore be directed to the CSL warehouse (telephone 9328 7322) or to the relevant Regional Pharmacy.