Coronavirus in Scotland: 'Wasted doses' of Covid-19 vaccine labelled 'disgrace' by NHS staff at EICC

NHS staff at the Edinburgh International Conference Centre (EICC) mass vaccination centre have raised concerns over Covid-19 vaccine doses being “wasted” due to an instruction for vaccinators to throw away unused vaccine at the end of a shift.

Members of the over 70s arrive at the EICC to receive their first dose of coronavirus vaccination on February 1, 2021.
Members of the over 70s arrive at the EICC to receive their first dose of coronavirus vaccination on February 1, 2021.

One worker told the Scotsman staff reacted “in uproar” after being ordered to throw out doses of the vaccine currently being administered to key elderly and vulnerable groups at the mass vaccination centre at the EICC.

NHS Lothian last night confirmed that so far 145 doses out of 3,900 delivered to the centre since Monday had been discarded for “various reasons” – a wastage rate of 3.7 per cent, double the national average.

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The health board said it has now changed its policy in light of objections from staff, but insists that “staff know they are not expected to discard any vaccine unnecessarily”.

Chief Nursing Officer Fiona McQueen confirmed vials of vaccine are usually assigned to just one vaccinator, but the Scottish Government was unable to say whether it is standard practice for staff to be told to discard vaccine doses they don’t get to.

One vaccinator at the EICC said he was given a “crystal clear” instruction that staff who reach the end of a shift with doses still in their vial must throw those doses away, as each vial was strictly the responsibility of one person for monitoring reasons.

A retired practice nurse who preferred not to be named, he said he and fellow staff members considered the practice a “disgrace”.

He told the Scotsman: “I, along with all of my vaccination colleagues, am disgusted with what we were told.

"We were told that each vial of vaccine we were given was our responsibility and should not be passed to anyone else or left unattended, which was acceptable. “However, at our induction team meeting colleagues, who had been at the centre yesterday, raised concerns that vaccines were to be thrown out at the end of a person's shift.

"This was confirmed by senior vaccinators and management staff, which caused a visible and audible uproar amongst the group of around 50 of my colleagues.

"As the vials are each vaccinator’s own responsibility, if they come to the end of their shift with doses left in their vial it is thrown out as it cannot be passed to a colleague to use the remaining dosage.

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“This is a disgrace. I do not know if this is the same across the country but it was certainly made fundamentally clear to us that should vaccine doses go unused, they would be discarded.”

NHS Lothian said on Thursday that following “staff concerns” a buddy system had now been set up to reduce “potential for waste”, sharing responsibility for a vial between two people.

“Ensuring patient safety and minimising waste are our main priorities in our vaccination centres and since the centres opened their doors on Monday, we have been able to further refine practices and procedures,” said Pat Wynne, NHS Lothian Director of Nursing for Primary and Community Care.

“There are systems in place to minimise waste, including a robust appointment system, which allows us to plan in advance, and queue management to ensure supply at each station is used.

“Staff raised concerns that there was still potential for waste so we have introduced a buddy system which allows staff to work in pairs and both to be accountable for their supply of vaccine. It also allows shifts to finish on time and provides greater flexibility for staff to take breaks.

"We have also reinforced the messages in our daily safety briefings at all of our sites to make sure that staff know they are not expected to discard any vaccine unnecessarily. We will continue to review the way we work and listen to our staff in the centres.”

Chief Nursing Officer Fiona McQueen said at the coronavirus daily briefing on Thursday: “There’s an industry norm of five per cent wastage being acceptable. In Scotland we're wasting less than two per cent of the vaccine.

"But if you draw the vaccine up, then you’ll administer it. So if a nurse or a vaccinator has 10 doses to administer, they then personally have to give that vaccine.”

NHS Lothian confirmed that, by Thursday, 145 doses had been discarded for a variety of reasons, including breakage, from a total of 3900 delivered to the EICC since the start of the week.

This is a wastage rate of 3.7 per cent, below the five per cent assumed by the Scottish Government in its Covid-19 Vaccine Deployment Plan, but double the current national average of 1.8 per cent.

A spokesperson for the Scottish Government said some vaccine wastage is “unavoidable” for a number of reasons, but did not mention discarded doses at the end of a shift.

“We have been clear we expect health boards to minimise wasted doses of vaccine, and have provided them with best practice advice on how to achieve this. However, some wastage is unavoidable for a variety of reasons based on the characteristics of the vaccine, logistical issues with cold chain supply, storage failure and/or specific clinical situations such as a breakout of Covid-19 in a care home,” they said.

“To date, our latest management information indicates a wastage rate of around only 1.8 per cent - well below our planning assumption of 5 per cent, which is a precautionary approach for worst case scenarios and in line with global best practice. We will continue to monitor wastage rates and regularly report back.”

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