Norway could avoid wasting Covid vaccines
CHRONICLE: Now everyone over 18 is offered a booster vaccine. Our research shows how the Norwegian health authorities can prevent vaccine doses from going to waste this time.
A survey from 2022 carried out by the news channel TV2 shows that almost one percent of the covid-19 vaccines in Norway (approx. 125,000 doses) were wasted in 2021. Recently, the Ministry of Health has selected everyone over the age of 18 to receive booster doses.
We believe that Norway can avoid unnecessary wastage of booster doses by better monitoring vaccine uptake; how many people in different municipalities have chosen a certain vaccine in a given time period?
Vaccination is still a key measure against covid-19
By the end of 2021, more than 3.9 million people in Norway had received doses of a covid-19 vaccine. Before people got the vaccines, the Norwegian Institute of Public Health (FHI) had to deliver 8 million doses to vaccination centers in different regions every week.
Equitable distribution of vaccines means ensuring access to vaccines to as many people as possible in the shortest possible time.
We have analyzed how FHI distributes vaccines in Norway in 2021. Despite a lack of information about who the Norwegian authorities have prioritized and where, we found that the distribution of vaccines was relatively fair. We found that with regard to the priority groups and the targeted locations.
Justice is the ultimate goal
Equitable distribution of vaccines means ensuring access to vaccines to as many people as possible in the shortest possible time. Justice stands for prioritizing people who are in situations with various vulnerabilities, such as background illnesses or older people.
Equitable distribution of vaccine is a complex mission. It depends on how many vaccine doses are available, whether healthcare personnel are ready to administer the vaccines, whether there is enough space to vaccinate populations, what priority groups and locations we have, and whether related medical needs (syringes, etc.) are available.
Fair distribution of vaccine becomes even more complicated when the responsible authorities have to assess vaccine skepticism in the municipalities.
Fair vs environmentally friendly vaccine distribution
It often happens that we have to sacrifice the environment in order to achieve a high level of fair vaccine distribution. In 2021, Norwegian health authorities had to quickly expand their network for the distribution of vaccines to reach very remote areas. They had to hire fast and reliable means of transport to be able to deliver to the whole country in a short time even to the one remote island that only needed 10 doses each.
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Time is short for planning the effective distribution of covid-19 vaccines
But some vaccines were distributed to places where they were not needed, because they were perceived to be ineffective. We found very little information about covid-19 vaccine uptake in various Norwegian municipalities for the entire 2021 period.
The lack of information on admissions may be due to either a lack of guidelines/systems in the municipalities to follow admissions, or a rush to administer vaccines, or both.
Although we could not confirm the cause throughout the project, experts we interviewed pointed to both causes during the interviews.
However, it is unclear how many vaccines have been discarded due to refusals at the vaccine administration centers. Perhaps you remember that almost 10,000 doses of Moderna vaccines were refused in Bergen because residents preferred Pfizer jabs?
Lack of information about vaccine uptake endangers justice and increases the environmental impact
Lack of information on vaccine uptake also has serious consequences for fair vaccine distribution. By throwing away 10,000 doses in Bergen (we don’t know what happened to them in the end), 10,000 people in other parts of Norway missed their chances to get their doses in time.
Further analysis shows that the amount of vaccines that are thrown away can be doubled if people are offered a choice between two or three vaccine types at the vaccination stations. Such offers were observed in several municipalities in Norway.
In some municipalities with low uptake of some particular vaccine brands, the authorities had to change/move vaccines to other municipalities to avoid huge amounts of wastage as a result of the vaccines’ short shelf life. The municipalities that failed to enter into such agreements had to dispose of extra vaccines as they could not return vaccines to central warehouses.
Vaccination uptake must be carefully monitored
The good news is that the wastage of vaccines in Norway is less than in several other high-income countries (such as 3.5 per cent in Australia). A likely solution to avoid wastage is to monitor vaccine uptake in real time. This information should inform about guidelines for subject allocation for the next batches.
Although official statistics show low rates of vaccine disappearance in Norway, no one can deny environmental influences. In addition, by discarding we risk fair vaccination in a global view.
One proposal is that the municipalities publish recordings of various vaccines on their websites and keep this information actively updated. In a short-term perspective, such information can prevent vaccine wastage in the near future.
When it is easier to get access to a number of vaccines, it is natural that the uptake of certain vaccines may have decreased in certain areas. Therefore, sharing admission information can contribute to more environmentally friendly vaccines, by reducing the likelihood of throwing vaccines away.
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