Table 4.

COVID-19 vaccination waste disposal best practices. Developed from Ref. [77].

Waste type	Safe & compliant disposal guidance	Solutions	Energy required/potential energy recovered
Syringes	Used syringes shall be captured in sharps containers and disposed of as RMW.	SDS	•Pyrolysis = 239 kWh/t and 9.9 kg/t of diesel [79] •Chemical Disinfection = 420 kWh/t [79] •Steam Sterilisation = 775 kWh/t and 48.1 kg/t of diesel [79] •Incineration = 0.4–8.4 kg/t [80] •Autoclave = 13.3 kWh/mon = ~0.44 kWh/t [81] Potential recovered energy = ~41.3 MJ/kg [82]
Vaccine Packaging	Can be disposed of as RMW. Follow manufacturer's instructions (e.g. returning)	RMW
Empty Vials	All vial waste to be captured in sharps containers to mitigate potential diversion and illicit intent. Once placed in a sharps container, the container should be managed as RMW.	SDS; NHPW
Full or Partial Vials (Residual doses)	Once placed in a sharps container, these items should be managed as RMW or as NHPW.	RMW; NHPW
Other Medical Waste	Gloves, gauze, cotton balls, bandages, and the like should not be placed in SDS. Either the regular waste or if potentially infectious material, disposed of as RMW.	RMW
Leftover Vaccine	Local autoclaving [83]/incineration (most common approach [84])	MBW, RMW or NHPW depends on the local regulation requirement
Dry ice	Please refer to CDC guidance for the disposal of dry ice [85].	CO2	0.14 kWh/kg [86]

Note: RMW = Regulated Medical Waste; NHPW = Non-Hazardous Pharmaceutical Waste; SDS = Sharps Disposal Solutions; MBW = Microbiology and Biotechnology Waste. The other type of medical waste treatment has been summarised by Singh et al. [87].