A new study has cast a sobering light on Uganda’s immunization efforts, revealing alarmingly high levels of vaccine wastage that threaten the country’s fight against preventable childhood diseases.
The research, conducted by Makerere University School of Public Health in partnership with the ministry of Health, examined facilities in Mukono and Kalungu districts, exposing gaps in logistics, training and community mobilization. Vaccine wastage, according to the World Health Organization (WHO), refers to the loss of vaccines due to use, decay, erosion, leakage or wastefulness.
It is calculated as the proportion of vaccines administered compared to the total issued. The study focused on six life-saving vaccines—BCG, OPV, IPV, PCV, Measles-Rubella, and DPT-HepB-Hib—routinely administered to children under Uganda’s national immunization schedule.
The findings showed that Uganda’s vaccine wastage rates exceed both national and World Health Organization (WHO) thresholds. For example, BCG wastage hit 70%, far above the WHO’s acceptable 50%. Measles-Rubella vaccine wastage stood at 58%, IPV at 31%, and OPV at 28%. Even single-dose PCV vaccines registered 17% wastage, ex- ceeding the 5% recommendation.
“These numbers are not just percentages—they are missed opportunities to protect children from deadly diseases,” said Dr. Simon Kasasa, one of the lead researchers. The study attributed the high wastage rates to several factors. Rural facilities, particularly health center IIs, recorded the highest losses due to sparse populations and poor access.
Often, multi-dose vials are opened even when only one child shows up for immunization, resulting in the rest being discarded within six hours, especially if the vaccines lack preservatives. While this approach is meant to reduce missed vaccinations, it significantly raises wastage levels.
In urban districts like Mukono, better population density meant lower wastage rates. But rural Kalungu painted a bleaker picture. Long distances, inadequate transport, and low turnout at outreach events forced health workers to discard unused doses, often due to cold chain failures, limited storage space, and expiration.
“Low community turnout is a big challenge. When only a few children come, we’re still required to open multi-dose vials, and that leads to wastage,” a nurse from Kalungu explained during the survey.
Economic implications are severe. Each wasted vaccine dose represents not only the cost of the drug but also expenses tied to storage, transportation, and staff time. The study warns that this inefficiency places added strain on an already stretched health budget and undermines the sustainability of immunization programs.
The research further found that 96% of open vial wastage stemmed from discarded reconstituted vaccines and 93% from unopened vials discarded after sessions. Other contributing factors included poor documentation, insufficient training of health workers, and vaccine hesitancy in some communities.
To tackle the crisis, experts have called for improved planning through data-driven models, adoption of lower-volume vials, decentralization of immunization efforts, and comprehensive retraining for frontline health workers. Community engagement is also vital.
“We must reframe our communication strategies to reach parents more effectively. Myths and misconceptions about vaccines are still widespread,” said Grace Kiwanuka, executive director of the Uganda Health-Care Federation.
She emphasized that educating caregivers is key to boosting turnout and ensuring fewer doses go to waste. Despite the challenges, Uganda remains committed to its immunization agenda. With support from WHO, GAVI, and UNICEF, the country is expanding access to vaccines nationwide.
According to WHO, Uganda contributed 5.1% of global malaria cases in 2023 and 2.9% of related deaths, showing how vital efficient vaccination is in reducing child mortality.
