Home » Health » Vaccines keep expiring, who will pay for them? – Free Press

Vaccines keep expiring, who will pay for them? – Free Press

Guatemala adopted a National Vaccination Plan against covid-19 late, starting with the most vulnerable population. Thirteen months after vaccinating the first adult, in the last stage of the process it was proposed to protect children between 6 and 11 years of age against the coronavirus, however, to date only 21.8 percent of this population has received the first dose, and the second, there is no certainty when they will receive it.

Although 25,232,320 entered the country (in 2021-2022), about 8 million doses of Sputnik V, AstraZeneca, Moderna and Pfizer were lost because they expired, but also due to oversights in the cold chain.

But who will be responsible for that millionaire loss? So far, there is no certainty about who is to blame for the damage caused to the health of Guatemalans.

The ministerial agreement that establishes how to proceed in these cases dates from 2011, and does not contemplate pandemic situations or epidemics such as covid-19. Therefore, in the opinion of the deputy Evelyn Morataya, it should be modified to be applied in health emergencies such as the current one, and that it also allows knowing what to do in the case of vaccines or expired medicines.

The norm establishes in article 4 that “they are causes of responsibility in the expiration of medicines and related products -vaccines- when it is verified that there was intent, fault, action, omission or negligence in their use, within the period of useful life” . If the above is verified, those responsible must replace the product or pay the amount thereof.

As part of the procedure that health workers must follow when having, in this case, vaccines that are about to expire, the rule establishes that they must prepare a record with the facts and circumstances that led to the expiration of the product. In addition to writing down all the characteristics of the biological. This would relieve them of any responsibility for the loss of the product.

In the case of the covid-19 vaccines, the reasons could be several, among them, that the biological was distributed with a few days of shelf life, as well as the refusal of the population to be vaccinated, despite the efforts of the vaccinators to promote the doses against covid-19.

But since the pita always breaks at its thinnest, under this article it is intended that the health personnel of Sololá and Escuintla pay Q520,900, because the biological assigned to their areas was not applied before the expiration date.

According to Eliú Mazariegos, director of the Comprehensive Health Care System -SIAS-, the directors of Health Areas are responsible for the Executing Units and cases such as the expiration of vaccines must adhere to what is established in the logistics procedures manual of the ministry that is in force.

Read more: Expired vaccines: These are the possible criminal and economic consequences of the expiration of millions of vaccines

Those in charge of the Health areas must document the procedure why the vaccines were not applied, then transfer it to the coordination of legal advice and internal audit to determine whether or not there was administrative responsibility.

“The health area has an entire administrative process to comply with, the fact that they have placed an alleged cash payment -to the health personnel-, does not necessarily have to be paid. There is an administrative process of counter-review and several processes that must be fulfilled prior to making the effective payment. It is not the last step, the one that they have to pay for,” said the director of SIAS.

“What has been suggested to the Directorate of the Health Area is to document all the processes that have been done to avoid the expiration of the vaccines, that is the responsibility of the Health Area,” he added.

For Morataya, the responsibility falls on the Executing Units, and they must follow the appropriate procedure to get rid of any blame.

“A record must be drawn up and say that there was resistance to the vaccine by the population, it must be stated that a whole strategy was carried out and that the population did not want to apply it. That brigades came out and the people did not receive it. There are many reasons and they are real, why people did not want to be vaccinated, and your responsibility as executing unit would no longer fall on you, if you show that you fulfilled all your functions, “adds the deputy.

They work on new deal

In a meeting last week between Mazariegos and Morataya, how Health works on the issue of the expiration of vaccines against covid-19 was discussed.

Last week, deputy Evelyn Morataya met with the director of SIAS, Dr. Eliú Mazariegos, to discuss how the Ministry works on the expiration of vaccines against covid-19. (Photo Ana Lucia Ola)

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Last week, deputy Evelyn Morataya met with the director of SIAS, Dr. Eliú Mazariegos, to discuss how the Ministry works on the expiration of vaccines against covid-19. (Photo Ana Lucia Ola)

From that meeting it emerged that a new manual of logistical procedures for vaccines and supplies is being prepared with its respective ministerial agreement for dealing with crises or health emergencies such as what happened with covid-19.

“Right now nothing is going to happen other than continuing with the 534-2011 agreement. As long as the Ministry of Health does not present, update or make a new agreement, it will continue to be applied,” Morataya said.

Also read: Health: the Sputnik V contract to buy another 8 million doses is still in “legal analysis”

According to the deputy, Health will deliver a draft on May 10 of said agreement, which will be accompanied by a manual of procedures to be used in pandemics or epidemics. This new document is being worked on in collaboration with the Pan American Health Organization.

Morataya is of the opinion that this agreement should cover not only the vaccines that are used in emergencies such as the covid-19 pandemic, but also the biological one that is applied in the regular vaccination schedule. An update of the current regulations is not enough, since the articles lag behind for the current times, due to the fact that vaccines come with a shorter expiration date.

We’re late again!

In the opinion of Zulma Calderón, health defender of the Human Rights Ombudsman (PDH), that the Ministry of Health think two years after the pandemic to create a new ministerial agreement that will give life to a logistics manual for the management of vaccines such as those for covid-19 is a sign that improvisation continues to be the constant in managing the health crisis in the country.

This step should have been taken from the moment the Law for the financing and acquisition of vaccines against the covid-19 coronavirus and the National Vaccination Plan were born.

“Wanting to frame the expiration of vaccines in the manual that already existed -the 534 agreement- is impossible and incongruous. It is not applicable, ”adds Calderón, since the doses against covid-19 are different from those used in the regular vaccination schedule. This is an atypical situation, and he shows that “we are again late with the administrative management of the pandemic.”

In the supervisions that the PDH has carried out on the issue of coronavirus vaccines, Calderón pointed out that most of the directors of the health areas refused to receive covid-19 vaccines with such a short shelf life. Despite this, they were sent.

He adds that this is inappropriate, since the ministerial agreement determines that supplies, medicines and vaccines cannot be received if they do not have at least one year of useful life.

The responsibility, both Morataya and Calderón, believe that it falls on the Health authorities who acquired a millionaire quantity of vaccines that would expire soon and that they did not have the logistics or the capacity to bring them closer to the population.

“We have had such scandals in Public Health with smaller amounts of expired vaccines from the regular schedule, but now nothing happens. Neither the Comptroller General of Accounts nor the Public Ministry does anything”, reproaches the representative of the Health of the PDH.

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