Vaccine wastage in Bangladesh.

The Government of Bangladesh and WHO collaborated in a retrospective vaccine wastage study to estimate overall vaccine wastage rates from January to December 2004 for BCG, measles, DTP and TT. Researchers looked at vaccine distribution and usage patterns in randomly selected districts at both fixed (Upazila) and outreach (Ward) service delivery levels. Wastage was similar at both delivery levels but ranged widely among the sites. Average rates were highest for BCG (84.9%, range 55-93%) and measles (69.7%, range 28-86%) and lower for TT (35.5%, range 10-73%) and DTP (44.4%, range 16-77%). Wastage resulted primarily from opened vials at the ward level but this was reduced at fixed sites where the multi-dose vial policy is followed. A large proportion (30-38%) of records were excluded from the analytic vaccine-specific databases due to data recording errors, mismatches between Ward and Upazila databases, or missing data. The study's results may provide methodological and programmatic guidance for other countries in addressing vaccine wastage issues.