Recommendation 6

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.