Auditor general: GN may have wasted up to 31 per cent of COVID-19 vaccines
Report presented at legislative assembly Tuesday; health minister says changes are already being started
Nunavut’s Health Department may have wasted one-third of its COVID-19 vaccines, according to a report presented Tuesday to the Nunavut legislative assembly by Canada’s auditor general Karen Hogan.
“We found that vaccination efforts were hampered by the lack of a pandemic plan and information systems to track, monitor and report on vaccine inventory,” Hogan told reporters in Iqaluit.
“As a result, the Department of Health may have wasted up to 31 per cent of the doses it received.”
Hogan’s report investigated the vaccine rollout in Nunavut during the pandemic between March 2020 and October 2022.
It focused on whether the GN’s departments of Health, Executive and Intergovernmental Affairs, and Community and Government Services managed the rollout effectively and equitably.
Waste occurred in expired doses, opened vials with doses that weren’t administrated, vials not kept at required temperatures, and storage and handling incidents.
While the GN reported wastage of 18,151 doses — 15 per cent of the total received as of September 2022 — the report noted “poor record-keeping and the lack of inventory tracking” meant its health department could not account for an additional 19,542 doses, or 16 per cent of the doses it received.
“To strengthen its response to future pandemics and mass vaccination efforts,” Hogan said, “the Government of Nunavut needs to set up proper information systems, including an inventory management system.
“This would also improve the delivery of health-care services to the territory’s population and reduce the burden on an overstretched workforce.”
Melanie Joanisse, director of performance audits at the auditor general’s office, said tracking vaccine inventory on a local level in Nunavut was done manually, in some cases using Microsoft Excel spreadsheets.
“The fact that there’s unaccounted for [vaccines] and that’s part of the lack of an inventory management system and that you lose track of what happens in the community — that’s of concern,” she told Nunatsiaq News.
Joanisse and audit principal Markirit Armutlu said the percentage of doses unaccounted for due to lack of automated inventory management is higher in Nunavut than in other jurisdictions.
An April 2021 report from Manitoba’s vaccine implementation task force found the province had wasted less than one per cent of its doses at the time.
In Ontario, a November 2022 report by its provincial auditor general Bonnie Lysyk found the province wasted 38 per cent of vaccine doses it received between February and June that year.
“Imagine in a community where you have a health-care provider and a nurse who can provide any sort of medication or a vaccine,” Armutlu said.
“If you don’t have an automated inventory, then at any point in time you’re not sure whether your medication or your vaccine is available, or whether what’s available is not expired and you can actually use it.”
Nunavut Health Minister John Main said he recognizes the importance of digitizing the vaccine inventory management process.
He said his department has already acted to improve vaccine rollout, in particular by raising the issue of a public health surveillance system for Nunavut with federal partners including Canada’s chief public health officer Dr. Theresa Tam.
“We have to realize … there were a couple of tools we didn’t have in the toolkit, and we still don’t have a toolkit in terms of a digital inventory management system as well as a public health surveillance system,” Main told reporters.
“We are working to fill those gaps, but we’re going to need funding and we’re going to need resources to do that.”
The auditor general’s report also recommends the GN update its pandemic-response plans.
Officials said that the plans and response guidelines were not used because they were obsolete, the report said. That led to “lack of clarity” over the roles and responsibilities of senior health officials.
Main said the GN’s response plan is already being updated, which will also be helpful in addressing other health issues such as tuberculosis outbreaks.
Armutlu and Joanisse said they recognize Nunavut faced unique challenges in rolling out vaccinations — the size and remoteness of the territory, community health centre closures, the need to fly in health-care providers to administer the doses, and inadequate facilities to properly store vaccines.
“We want to highlight that moving forward, [it’s about] learning from the current pandemic and being able to update the pandemic plans,” Joanisse said.
The auditor general’s report also recommended tracking completion of orientation and training programs for health-care staff, monitoring whether their licenses and certifications are current, and providing regular reports of overdue training and expired licenses or certifications.