What do we do with all the expiring Covid vaccines?

The Covid-19 virus is possibly still lurking not just globally but also in Sri Lanka infecting isolated cases compared to the large clusters that broke out during the past two years.

So, with the waning of the many phases of the SARS Cov-2 virus in the country, a large consignment of Pfizer-BioNT vaccines has passed its extended shelf life on 31 October 2022.

No Decision

Deputy Director General (DDG) Disaster Management and Emergency Response, Dr. Hemantha Herath noted that the Health Ministry is yet to decide as to what was going to be done with regard to the sizable number of vaccine vials that had crossed their extended date of expiry at the beginning of this week. “It is not as if the vaccines would turn into fowl smelling vials of putrid water as if they will get spoilt after ending their shelf life, he observed noting that the Health Ministry was yet to come up with a proper plan to destroy them”.

Fielding questions in this regard Dr. Herath said that the expired vaccines would not be sent to their country of origin but would have to be destroyed in Sri Lanka.

About six million Pfizer doses have exceeded their shelf life by 31 October this year. With the shortage of funds, the Health Ministry faces the dilemma of having to wait for a time conducive to be able to see as to how the vaccines can be destroyed, Dr, Herath noted. “We may even have to obtain the assistance from special institutions on a procurement basis to have the vaccine vials destroyed, he explained.  

Extended time and repeated calls

The country’s Health Ministry extended the shelf life of the Pfizer’s vaccines already imported by three months on recommendations of the World Health Organisation (WHO).

The Ministry issuing a statement at the time said the Director of Regulation and Prequalification Department of WHO had communicated to the Director of the UNICEF Supply Division that the shelf life of the Pfizer-BioNTech vaccine with unopened vials stored at temperatures between -90 to -60 degree Celsius had been recommended to an extension of 12 months from its earlier nine-month deadline.

Upon those recommendations, the Ministry officially extended the Pfizer vaccines vials received under FN 5436, FN 2898, FM 9281 and FM 5450 batches till 31 October 2022 from their initial date of expiry which was of 31 July 2022.

The country purchased approximately 18 million Pfizer-BioNTech vials for the first and booster doses. The lacklustre response by the public to the booster doses following the first and second doses, urged the Health Ministry to prompt persons above 20 years to have the second booster shot as well.

At least 17.1 million people were administered with the first dose of the Covid vaccine. Over 14 million were given the second dose.

But as of 30 October 2022 while 8,220,002 of the population, who received the first and second doses, had got the first Pfizer booster shot. Of them too only 202,571 took the second booster shot also by BioNTech’s Pfizer.

The Health Ministry repeated its calls for the public to take the first and second booster doses with the spike witnessed in Covid-19 cases and deaths towards the month of July this year. However, poor public response was seen owing to the fear caused by the first and second doses.

Swiss situation

According to international reports quoting the Government of Switzerland, the country had been set to destroy nine million doses of Moderna (MRNA.O) Covid-19 vaccines that had reached their date of expiry, with another 5.1 million vaccine jabs remaining to expire by February 2023.

The reports further said that the wastage reflected the Swiss strategy of having “ordering more vaccines than was needed to ensure that its population of around 8.7 million would be able to get sufficient supplies even in the event of supply shortages or quality issues.”

In Sri Lanka too accusations were levelled against the Government and Health Ministers of allegedly making over-estimated purchases of the Pfizer vaccine – especially at a time when the country is facing an economic crisis.

Scaling down 

DDG Disaster Management and Emergency Response noted that the Ministry would scale down its Covid vaccination programme–especially with the public reluctance towards taking the booster doses. “We already have a childhood immunisation programme, this too would be toned down so that those who require any of the vaccine doses could get it at the nearest Medical Officer of Health (MOH),” he said. However, if the particular dose was not available the person could brief the Ministry of their required dose and obtain it from that particular office or from a place where it is available.

Conclusion

The health service is currently experiencing a post Covid-19 economic crisis causing outbreaks of drug shortages, malnutrition and vehement attempts to shush its trade union leaders. The Acting Director Epidemiology Unit, Dr. Samitha Ginige who did not wish to comment on the process of destroying vaccines was however very verbose when egging the public to take the Pfizer vaccine which even at that time was almost on the verge of expiring till the WHO extended its shelf life. But now with six million Pfizer vaccines having passed shelf life on their hands the Health Ministry does not seem to have inkling as to how it was going to deal with them.