National trends and operational drivers of vaccine wastage in Uganda, 2020-2025: a descriptive analysis of four tracer antigens

The study analyzed vaccine wastage in Uganda during 2020-2025 using data on four vaccine types: BCG, MR, OPV, and DPT. The median national wastage was 40.6% for BCG, 25.9% for MR, 10.0% for OPV, and 9.2% for DPT. OPV vaccine showed a positive trend with wastage declining from 12.8% in 2020 to 8.0% in 2025. While OPV and DPT vaccines remained mostly within Uganda's thresholds, BCG and MR vaccines showed higher and more variable wastage rates. Lower-level health facilities (Health Centre II and III) consistently had higher wastage than hospitals. The main causes of wastage were low session attendance (66%), non-compliance with multi-dose vial policy (28%), and vaccine expiry (12%).