Professor Peter Collignon, author of the editorial, comments:
I agree with Ken Bickle that considerable waste was associated with the H1N1 immunisation program. Full details are not readily available because of 'commercial in confidence' agreements. From media reports it appears that CSL received about $120 million from our Federal Government for 21 million vaccine doses.1 An added potential cost to the Government is the indemnity CSL received for any serious adverse events resulting from the vaccine.
Only a quarter of these doses were distributed1and the vaccine was presented in multi dose vials. Multi dose vials result in much higher vaccine wastage compared to single-use preloaded syringes.2 I suspect that 30% of the distributed vaccine doses were never administered. Additionally, most of the vaccine given was to those over 65 years.3 This age group already had high levels of pre-existing immunity to H1N1 (swine flu) and thus vaccination was not likely to have been much benefit for them.
The World Health Organization has documented the major infection problems associated with unsafe injection practices.4 This results in millions of viral and bacterial infections every year, especially in developing countries.5 Multi dose vials and immunisation practices may only be a small component of this problem, but this risk can be virtually eliminated with the use of preloaded single-use syringes for vaccination (which we use for seasonal flu vaccinations here). Using single-use preloaded syringes also results in considerably less wastage of vaccine.2 This reduced wastage will usually more than compensate for their small additional cost (about 14 cents).2
Multi dose vials may sometimes have a place for the delivery of inexpensive vaccines in countries with low resources and poor infrastructure.2 They have no place in a country such as Australia.
