COVID-19 vaccination: Centre issues guidelines for safe waste disposal of syringes

By Priyanka Sharma
New Delhi [India], December 14 : As COVID-19 vaccination programme will soon start in India, the Union Health Ministry has pledged for "One needle, One syringe, Only one time" and prepared guidelines for safer disposal of used injections.
The Centre in its COVID-19 vaccine guidelines has directed states to ensure safe injection practices during the biggest vaccination programme to be held in India.
The government strategy is "One needle, One syringe, Only one time". Health experts opine that it will probably create large amount of syringe waste during vaccination programme.
The government's National Expert Group on Vaccine Administration for COVID-19 (NEGVAC) recommended that a prioritised population groups will specifically be vaccinated. It includes: (i) Approximately 1 crore, healthcare workers (HCWs) healthcare providers and workers in healthcare setting, (ii) about 2 crore frontline Workers (FLWs)which includes personnel from state and central police, armed forces, home guards, civil defence and disaster management volunteers, municipal workers, (iii) approximately 27 crore prioritized Age Group population above 50 years and persons below 50 years with associated co-morbidities.
According to the document, a safe injection is one that does not harm the recipient, does not expose the Health Care Workers (HCWs) to any avoidable risks and does not result in waste, which is dangerous for the community and environment.
"Wash your hands with soap before and after the vaccination session and sanitize with 70 percent alcohol-based sanitizer or wash your hands with soap and water after vaccinating each beneficiary. Cover any small cuts on the service provider's skin. Avoid giving injections at the injection site where there is local skin lesion, cut or dermatitis," highlights the government document.
It said, "Always use Auto-disable (AD) syringes during the COVID-19 vaccination campaign. These syringes prevent person-to-person transmission of blood-borne pathogens. Use a new sterile packed AD syringe for each injection for each beneficiary," it noted adding that do not use AD syringes that have damaged packaging, or have passed the manufacturer expiry date. Do not pre-fill syringes and do not attempt to recap the needle as this practice can lead to needle-stick injuries."
"Immediately after injecting the beneficiary, the AD syringe must be cut from the hub (plastic part at base of needle) using the hub cutter and cut part of the syringe put in the red bag. Do not put the syringes on the table or on a tray after," the document further added.
"For safe disposal of injection waste, the government has said that cut the hub of the AD syringe immediately after administering the injection using the hub cutter. Cut needles will get collected in the puncture proof container of the hub cutter," it mentioned.
"Segregate and store the plastic portion of the cut syringes in the red bag. While plastic wrapper and the cap of the syringe should be treated as municipal general waste, the use of hub cutter should be made correctly, store used cotton swab in yellow bag after administering the injection," it said.
Besides, the used, unused, partially used vaccine vials should be returned to the cold chain point as per existing adverse events following immunization (AEFI) guidelines for proper disposal, they said.
"Carry the segregated immunisation waste generated during outreach sessions and hand these over to the PHC for further disposal. Wash the hub cutters properly with sodium hypochlorite before reuse. Store broken vials in the puncture proof blue container," stated the document.
The document has also underlined that all vials (used/empty, unused and partially used) must be returned through Alternate Vaccine Delivery (AVD) to the vaccine distribution / ILR point, maintaining a reverse cold chain. Completed and signed tally form should also be returned with vaccine carrier.
Most importantly, the government has advised the states to ensure that unopened vials should be returned and properly marked and stored immediately at the correct temperature.
"On the next day, these marked vials must be supplied and used first ensure that all used/empty COVID-19 vaccine vials at the end of the session are kept in a separate zip lock bag to return to ILR point," the document stated.
"Always keep used COVID-19 vaccine vial returned from the field separately contained in a zip lock bag / box with proper cold chain till the next session or 48 hours which ever earlier (as per existing AEFI guidelines)," it said.