GPs should ignore calls to throw away usable COVID-19 vaccine, says RCGP

Suggestions that vaccination sites should throw away usable doses of COVID-19 vaccine should be 'dismissed out of hand', the RCGP has warned.

Clinical waste (Photo: Universal Images Group/Getty Images)

GPs have raised concerns over guidance that suggests unused vials of Oxford/Astra Zeneca vaccine moved from a main primary care network (PCN) vaccination site to another practice within the PCN should be destroyed after 24 hours even if they have been stored appropriately.

Concern over the wording of the guidance comes after reports from GPs and other NHS staff of vaccination sites being told not to administer second doses even if the alternative is to throw away unused vaccine amid an NHS drive to focus on offering first doses to as many people as possible.

The Independent has reported that hospitals have been warned 'they could lose their licence to deliver coronavirus vaccines if they give second doses to anyone before 12 weeks have passed since their first jab'.

COVID-19 vaccine

The guidance on moving stocks of the Oxford/Astra Zeneca vaccine between sites within PCNs, published last week, says: 'The vaccine must be used as soon as it is received rather than being stored. This has been clarified to mean that in practice the vaccine could be stored in the GP practice for a maximum of 24 hours.'

The guidance adds that 'vaccines must be put in the correct vaccine refrigerator without delay and stored at 2oC to 8oC until required', and adds: 'At the end of the session discard any remaining vaccine vials into a yellow lidded sharps bin, ensuring the label of the vial packaging is defaced or destroyed before disposal.'

Leicester, Leicestershire and Rutland LMC's Dr Grant Ingrams questioned on Twitter why the guidance said GPs should throw away unused vaccine after 24 hours 'despite a shelf life of six months'.

Meanwhile, reports from doctors that they have been told not to use vaccine outside the first eligible cohorts or for second doses even to avoid wastage appears to clash with the wording of the COVID-19 vaccination enhanced service for primary care.

Vaccine wastage

The enhanced service document says: 'Vaccination will be permitted to patients outside of the announced cohort where the GP practice can demonstrate exceptional circumstances, that it is clinically appropriate and where resources would otherwise have been wasted.'

RCGP chair Professor Martin Marshall said: 'Any suggestion that usable COVID-19 vaccines should be thrown away instead of being used to vaccinate should be dismissed out of hand.

'Our vaccine supply is precious and where possible, every dose should be used to protect patients from this terrible virus.

'GPs and our teams - and colleagues across the health service - are working incredibly hard to deliver the COVID-19 vaccination programme and are making good progress.

'We’re following NHS England guidelines to prioritise patients in accordance with the JCVI’s prioritisation list. In cases where there may be spare vaccines, such as when patients do not turn up for their vaccination, GPs will use their clinical judgment and take sensible measures, such as contacting other vulnerable patients or frontline healthcare professionals, who are also on the COVID-19 vaccination priority list, to ensure that use of supply is maximised.'

Daily updates on doses of vaccine administered in England show that vaccination sites are continuing to administer small numbers of second-dose jabs. In England, a total of 2,723 second-dose vaccinations were administered on 20 January.

GPonline approached NHS England and the DHSC for a response to concerns that official policy was leading to vaccine wastage, but has not received a reply.

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