Source · Select Committees · Public Accounts Committee
Recommendation 6
6
While vaccine wastage was well below assumptions in 2021, NHS England believes the level could...
Conclusion
While vaccine wastage was well below assumptions in 2021, NHS England believes the level could increase in 2022, which would be regrettable. Up to the end of October 2021, the NAO estimated COVID-19 vaccine wastage levels for England of under 5%, a remarkable figure—especially considering the Pfizer vaccine’s transport and storage ultra-low temperature requirements—well below the programme’s initial assumptions, and, according to NHS England, low by historical standards. NHS England was expecting wastage levels to increase in 2022, in anticipation of a fall in overall demand and resulting difficulties in using up supplies. The programme has already seen how reduced demand can impact on wastage: in 2021, it had to write off around 1.9 million AstraZeneca doses as demand fell following changes to clinical advice on how AstraZeneca should be used. It seems very likely that the programme will have an excess of supply over the next year: the Taskforce is finding it difficult to predict demand for 2022 but it has consciously taken a conservative approach to procurement, on the basis that too much is better than too little. Nevertheless, there are opportunities to minimise wastage at all stages of the supply process, including careful handling and stock management by local sites; and early action by the Taskforce to tee up international donations and swaps, and to reschedule deliveries. Recommendation: As part of the Treasury Minute response, the Taskforce, NHS England and UKHSA should update the Committee on levels of wastage across the programme, the number of doses donated internationally, and the number of doses still to be supplied by the end of 2022.
Government Response
Not Addressed
HM Government
Not Addressed
6.1 The government agrees with the Committee’s recommendation. Recommendation implemented 6.2 The government has numerous safeguards and procedures in place to reduce the risk of dose wastage. 6.3 UKHSA manages the central storage and distribution of COVID-19 vaccines for the UK programme. As of 30 July 2022, 946,525 doses of COVID-19 vaccines were destroyed or identified for destruction, accounting for 0.46% of the total vaccine volumes delivered and brought under UKHSA management. 6.4 NHSE is responsible for any wastage once vaccines have left UKHSA’s warehouses. As of 12 July 2022, the England programme had administered 125.9 million COVID-19 vaccinations. 5.04 million (4%) doses have been recorded as waste by vaccination sites and under 1 million (0.7%) doses reported as waste, expired or damaged by wholesale partners. These figures are significantly lower than the initial planning assumption of 15-20% total wastage. 6.5 Doses have been offered to other countries where not required by the UK domestic programme, though demand is now very low. The UK has offered the 100 million doses it committed to donate in 2021 and by 30 June 2022, the UK had donated over 84.4 million doses. 6.6 Recent procurements, targeting 2022 and 2023, have been against a reasonable worst-case scenario assumption. To date in 2022, it has not been necessary to extend the campaigns in line with the reasonable worst-case scenario. This, along with other factors including global supply for vaccines outstripping demand, will likely lead to an increase in wastage. 6.7 To combat wastage, the government has implemented an integrated business planning process to ensure supply risks are accounted for, contingency measures identified, and forecast demand is met as closely as possible. Contractual options to reduce, defer, or cancel inventory are also employed where available. 6.8 Details of future supply are commercially sensitive and so will be shared in confidence with the Committee in a letter.