Bandar Seri Begawan - As Much as $30,708.86 was lost in 2008 in the form of vaccine wastage, the head of Maternal Child Health Services, Ministry of Health, yesterday said.

Dr Hjh Roslin Hj Sherbawi said that a clinical audit on multi-dose vaccine wastage, carried out by her team between the months of January and December in 2008, showed that many of the clinics audited had unacceptable vaccine wastage as a result of accepting inoculation recipients without appointments.

Her team found out that as much as $19,143 of the measles, mumps, and rubella (MMR) vaccines were wasted.

Likewise, $4,700 and $6,865.86 of the Polio and CDT (mixture of diphtheria toxoid and tetanus toxoid) vaccines were discarded during immunisation session.

"We carried out audits in 13 Mother and Child Health Clinics located across the Brunei Muara District because it was the most densely populated district with the highest workload," she said during the launching of the "7th National Perinatal Symposium 2009" symposium held yesterday at The Chancellors Hall in Universiti Brunei Darussalam.

She attributed this wastage to either heat exposure of unopened vials of the vaccines or the disposal of opened vials of excess vaccines at the end of a vaccination session.

When comparing results, her team observed the best performing clinic, meaning with minimum wastage had an appointment system for multi-dose vaccinations and that the appointments were recorded in a register book. Two nurses were also delegated to monitor these multi-dose vaccine appointments and that patients were reminded of their appointments.

The poor performing clinics, however, had a walk-in system without any registration records for appointments. With no available recipients, opened vials with left-over vaccines were then discarded at the end of each session.

Findings from the audits were then used to form recommendations which were then presented to all clinics in April. The best clinic was also invited to present and share their immunisation practice including an explanation of their appointment system.

"(We) discussed how to improve the appointment system and clinical practice in order to decrease vaccine wastage," said Dr Hjh Roslin, adding that a standard operating procedure for the management of multi-dose vaccines was also designed. "(Based on the recommendations), all multi-dose vaccinations should be given through an appointment system and a call and recall system should be in place to remind parents," said Dr Hjh Roslin. Such implementation of change was put in place in May 2009 and a re-audit for the period between May and October was done six months later.

While updated values were not disclosed, the head of Maternal Child Health Services informed the participants that the second audit had showed significant improvements in most of the clinics where they had reduced their percentage of vaccine wastage to an acceptable level.

There were approximately 200 participants, comprising staff and personnel from various health departments under the ministry.-- Courtesy of The Brunei Times

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