A framework for environmentally sustainable vaccination programmes
Abstract
Background: Creating health systems which facilitate reductions in carbon emissions and are adaptive to the impacts of climate change remains a priority. Vaccination programmes help prevent illness and reduce healthcare demand and are among the most cost-effective interventions. But they also generate environmental impacts through production, logistics, service delivery, travel, and waste. This pilot study aimed to define a sustainable adult flu vaccination programme and assess ways to measure emissions in NHS Scotland.
Methods: This mixed-methods pilot study, a collaboration between NHS Grampian, Public Health Scotland and NHS Tayside, led to the creation of an integrated framework to: (1) map patient pathway emissions across the stages of the vaccination process; and (2) map supply chain emissions across storage, transport, delivery. Quantitative emissions data were collected for: fleet travel, building energy use and waste volumes from selected vaccination sites. Stakeholder engagement identified data gaps and barriers to best practice. A conceptual framework for conducting a cost-effectiveness analysis of sustainable adult flu vaccination programmes and an associated carbon footprint calculator were developed.
Results: The study demonstrated that emissions arise across the full vaccination pathway, with delivery-level factors such as waste management, energy use, and transport being the most measurable and actionable at Scottish health board level. Interventions such as downsizing clinical waste bins, improved segregation and reduced inappropriate PPE use also indicated potential benefits.
Conclusions: The integrated patient and supply chain framework developed in this study provides a transferable foundation for assessing cost-effectiveness and carbon footprint across flu vaccination programmes, supporting progress towards net-zero health systems. The additional carbon calculator can be used to guide practical changes to the delivery pathway to lower emissions.
Key messages: • Practical emission reductions with regards to adult flu vaccination programmes can likely be achieved.
• Practical emission reductions can likely be achieved through targeted changes to waste and energy use, supported by staff engagement and clear guidance.
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BibTeX
@article{chalmers2026framework,
title = {{A framework for environmentally sustainable vaccination programmes}},
author = {NG Chalmers and R McNee and R Hoggett and J Thomson and S Ghebrehewet and C-L Walker and L Hamilton and P Mackie and F Garbe},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1164},
url = {https://doi.org/10.1093/eurpub/ckag169.1164},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - A framework for environmentally sustainable vaccination programmes
AU - NG Chalmers
AU - R McNee
AU - R Hoggett
AU - J Thomson
AU - S Ghebrehewet
AU - C-L Walker
AU - L Hamilton
AU - P Mackie
AU - F Garbe
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1164
UR - https://doi.org/10.1093/eurpub/ckag169.1164
AB - Background: Creating health systems which facilitate reductions in carbon emissions and are adaptive to the impacts of climate change remains a priority. Vaccination programmes help prevent illness and reduce healthcare demand and are among the most cost-effective interventions. But they also generate environmental impacts through production, logistics, service delivery, travel, and waste. This pilot study aimed to define a sustainable adult flu vaccination programme and assess ways to measure emissions in NHS Scotland. Methods: This mixed-methods pilot study, a collaboration between NHS Grampian, Public Health Scotland and NHS Tayside, led to the creation of an integrated framework to: (1) map patient pathway emissions across the stages of the vaccination process; and (2) map supply chain emissions across storage, transport, delivery. Quantitative emissions data were collected for: fleet travel, building energy use and waste volumes from selected vaccination sites. Stakeholder engagement identified data gaps and barriers to best practice. A conceptual framework for conducting a cost-effectiveness analysis of sustainable adult flu vaccination programmes and an associated carbon footprint calculator were developed. Results: The study demonstrated that emissions arise across the full vaccination pathway, with delivery-level factors such as waste management, energy use, and transport being the most measurable and actionable at Scottish health board level. Interventions such as downsizing clinical waste bins, improved segregation and reduced inappropriate PPE use also indicated potential benefits. Conclusions: The integrated patient and supply chain framework developed in this study provides a transferable foundation for assessing cost-effectiveness and carbon footprint across flu vaccination programmes, supporting progress towards net-zero health systems. The additional carbon calculator can be used to guide practical changes to the delivery pathway to lower emissions. Key messages: • Practical emission reductions with regards to adult flu vaccination programmes can likely be achieved. • Practical emission reductions can likely be achieved through targeted changes to waste and energy use, supported by staff engagement and clear guidance.
SN - 1101-1262
SN - 1464-360X
ER -