Challenges, optimization, and best practices in COVID-19 Vaccination: Experiences from a tertiary care urban vaccination centre of Himachal Pradesh

The COVID-19 vaccination rollout in Himachal Pradesh faced significant operational hurdles. This study evaluates strategic responses at an urban COVID Vaccination Centre (CVC) to maximize vaccine utilization and delivery. As eligibility expanded to adults aged 18+, adaptive strategies were implemented to achieve zero dose wastage despite restrictive session constraints and online-only booking complexities. Key interventions included a "Zero Tolerance to Dose Wastage" policy, on-site beneficiary confirmation, and extended hours. By utilizing low dead space syringes, the centre extracted 11–12 doses per 10-dose vial, surpassing standard expectations. A systematic protocol for refilling leftover slots ensured maximum vial utilization. Between May and June 2021, 1,221 individuals were vaccinated—exceeding the 1,100 published slots—by accommodating 168 additional beneficiaries through dedicated outreach. The centre enhanced equity by providing digital booking support for underserved populations and achieved a peak throughput of 371 vaccinations in six hours. Ultimately, 41,500 doses were administered across 595 sessions, saving ₹528,750 through optimization. This framework, anchored by the principle "One Dose Equivalent to One Life," provides a replicable model for sustainable public health impacts during crises amidst the ensuing pandemic.