Ontario auditor general finds COVID-19 vaccine wastage, unco-ordinated bookings

vaccine gen cp

Ontario wasted 38 per cent of COVID-19 vaccine doses between February and June because it overestimated demand for boosters, said the province's auditor, who also found the government ran a disorganized booking system and doesn't fully track adult vaccinations.

Auditor general Bonnie Lysyk said in her annual report Wednesday that overall COVID-19 vaccine wastage is nine per cent, or 3.4 million doses.

About half of that could have been avoided with better forecasting of demand.

Wastage rates varied quite a bit between public health units, and one private company wasted 57 per cent of its supply between May 2021 and May 2022, but the province hasn't determined the causes, Lysyk said.

She also identified problems with the system for booking vaccination appointments, as the province created its own portal but about half of public health units are using their own, while some hospitals, pharmacies and private companies are using their own methods as well.

``Multiple booking systems also encouraged Ontarians to 'vaccine shop' by registering for multiple appointments to try to get either the quickest appointment or a specific vaccine brand,'' Lysyk wrote in the report.

``The continued absence of a centralized booking system (as of August 2022) increases the likelihood of unnecessary wastage continuing into the future since such no-show appointments can result in more wasted doses of vaccine.''

Multiple bookings led to about 227,000 no-shows in 2021 in the provincial booking system alone, the auditor found, which likely contributed to vaccine wastage.

The lack of a centralized booking system also led to inconsistent controls and checks to ensure that when bookings were opened up to particular groups, such as health-care workers or immunocompromised people, only those eligible were actually making appointments, Lysyk found.

Family doctors were underutilized in the vaccine rollout, Lysyk found, noting that the compensation structure provided a disincentive for them to administer shots in their own offices.

Physicians were paid between $170 and $220 an hour by the government to work at vaccination sites operated by a public health unit or a hospital, while doctors were paid just $13 per dose to vaccinate in their own offices.

As well, Lysyk found that physicians at clinics were paid much higher rates to administer shots than nurses, who were paid between $32 and $49 an hour, and pharmacists, who were paid between $30 and $57 per hour.

The Ministry of Health conducted a study of procedures and effectiveness at nine mass immunization clinics between the summer of 2021 and December of that year and finalized the study this July, Lysyk wrote, but did not share results with public health units to help them plan for the rollout of the bivalent vaccines this fall.

As well, the auditor says that despite the Ministry of Health saying in 2014 that it was going to expand a system used for tracking student vaccinations to keep vaccine records for all Ontarians, that has not happened.

Lysyk found that contracts for goods and services related to COVID-19 were timely given the urgency of the pandemic, but better co-ordination could have reduced some costs.

About $18.7 million was paid to private companies for underutilized mobile COVID-19 testing, the auditor found.

``Vendors were paid a guaranteed minimum daily payment to cover overhead costs even if a minimum number of COVID-19 tests were not performed,'' Lysyk wrote in the report.

One vendor charged its guaranteed minimum daily payment of $8,255 whether zero tests or 250 tests were performed in a day, the report said.

The audit identified 105 instances, representing $800,000, in which vendors got their guaranteed minimum daily payment despite testing no one that day.