As eligible Americans line up for their two-shot escape from Covid-19 amid an excruciatingly slow vaccine rollout, thousands of doses are going to waste or are getting held up. Some are dumped because of power failures or accidentally unplugged freezers. Others are lost when a vial slips from a nurse’s hand and spills on the floor. Still, more is regularly lost when the window for using the sensitive preparation expires, and from so-called “high-dead space” syringes.
But just how much of this precious vaccine that’s in such a precariously short supply is going to waste?
TheStreet sought to answer this question last week, but -- after contacting the Food and Drug Administration, the Centers for Disease Control and Prevention and health departments of 50 states -- discovered there is no publicly available answer -- at least not yet.
“Government agencies are keeping this data close to the chest,” said Prof. Ted Ross at the University of Georgia's Center for Vaccines and Immunology, in a brief email to TheStreet when asked to comment on the difficultly getting numbers about wasted vaccines.
Poking Around for Answers
To find the answer of how many shots have been lost, or tied up because temperature questions, TheStreet first sent an email to the FDA, which advised talking with the CDC, noting that the agency "may refer you to local health departments."
The CDC responded the next day, claiming it was requiring states to provide it the data, but that the numbers were not yet publicly available.
“If vaccine wastage occurs, it should be reported into CDC’s Vaccine Tracking System. ... We are working to figure out how to provide this data online in the future when the data is more complete,” said CDC spokeswoman Kristen Nordlund in an email to TheStreet. Follow-up requests for more details and an actual figure or ball-park number were not returned.
TheStreet meanwhile asked state health departments, giving about a 24-hour response deadline or more.
But only a small number of states actually responded, and only a few –including Arkansas and Colorado – answered with exact numbers and reasons.
Recent headlines, however, have told of thousands of dumped or held up shots. Nearly two thousand doses of Moderna (MRNA) - Get Report were reportedly trashed in Massachusetts because of an unplugged freezer and nearly 900 more in Ohio were wasted over a refrigeration mishap by a private provider. Also, thousands of doses of vaccines were temporarily held up in California over allergy concerns, while thousands more were held up in Maine and Michigan because of questions over temperature problems. Earlier, enough doses for 500 people were lost in Wisconsin because a pharmacist allegedly had deliberately let them go bad, according to news reports.
Yet, only one state with those publicized incidents responded to TheStreet’s request: Maine.
That state claimed that no doses had been wasted, and when asked about the Moderna shots said that its share of the shipment -- 4,400 doses -- were stored at colder than the acceptable temperature range but had not yet been discarded.
"Maine CDC is awaiting word from the federal government and Moderna about whether these doses may be used. None of these doses were administered to people in Maine. None have been discarded," said a health department spokeswoman.
By contrast, a press release put out by Michigan's health department said its share of shots would need to be replaced.
One state with notable but not widely publicized problems, however, did respond with details of waste and what happened. Colorado, which lost nearly 600 doses so far, acknowledged that 300 Pfizer (PFE) - Get Report vaccines were deemed unusable after a portable vaccine storage unit malfunctioned, an additional 165 doses were trashed because of a power shortage caused by high winds, and 109 more doses went unused for “a variety of causes,” such as dropped vials, faulty syringes or needles, or damage in transit.
“Overall, this is less than .1% of the almost 600,000 doses allocated to Colorado,” said a health department spokesperson.
Arkansas state officials were the first and quickest to respond, with a detailed spreadsheet of the 100 doses lost – mainly because of accidents.
But some state health officials -- like the one in Maine -- claimed they miraculously had zero lost doses.
“I am not aware of any discarded vaccine,” said Sarah Ekstrand, a public information officer in Iowa’s Department of Public Health.
Alabama, Delaware, Mississippi, Virginia and West Virginia made similar claims.
Several other states acknowledged small problems, which would be expected in any vaccination program.
Brooks Baehr, a health department of Hawaii spokeswoman, said she only heard of two stories of doses not used, including five doses discarded or wasted and some doses that went unused at the end of the day “when there were no more arms available” to get the injections. “I know the number of doses discarded is far fewer than the number of extra doses we have extracted from vaccine vials.”
Idaho and Oklahoma officials gave a similar answer, with no numbers. Wyoming said it had only lost 35 doses for a variety of reasons and North Dakota said eight doses were lost.
Tennessee officials said that "a few shipments" received from distributors with out-of-range temperatures were returned and replaced, but did not give any numbers.
Nevada signalled that it still has questions that have not been addressed by federal officials over how to deal with vaccine issues, but gave no details or numbers.
That state is working with vaccine manufacturers to "assess any temperature excursions or other issues with potentially unusable doses," said Shannon Litz, a spokesperson for Nevada’s department of Health and Human Services. "At this time federal guidance has not been provided on reporting or disposal of those doses.”
Litz's statement, however, appeared to contradict one made by the CDC, which had told TheStreet that, “to reduce the chances of vaccine wastage, CDC has provided guidance on the proper management of the vaccine to jurisdictions and providers, worked with health departments to train clinic staff, and provided tools to facilitate vaccine administration.”
Taking a Jab at Stopping Vaccine Waste
While it’s common to see a small percentage of any vaccine go to waste in general – some estimates put the rate around 1%-5% annually – the Covid-19 vaccine is in desperately short supply so far. Also, both vaccines require cold storage at freezing temperatures, with Pfizer's at extremely low ranges not found in common refrigeration equipment. Once the vials are taken out of the freezer, they only have about 6 hours to be used before going bad.
“So, when they have those available doses ready,” said Brian Toolan, head of government strategy at logistics software service company Everbridge (EVBG) - Get Report, the shots must be used or discarded.
This becomes a problem, he said, if there are appointment no-shows or if clinics can’t get as many patients as they expected on a given day.
“If they have 2,000 doses available, and only 1,500 show up… it turns into a waste issue,” Toolan said in a phone interview Sunday.
Everbridge, which bills itself as a “critical event management” service, is starting a program on Monday with West Virginia to help with its vaccine distribution program and is already working with a county in Florida.
The company promises that its logistics software service will help match doses with eligible state residents and help eliminate waste by both helping ensure no shots go unused -- such as by notifying residents near a vaccination site of leftover shots -- and by monitoring any temperature changes and alerting health care workers who can try to resolve problems before vaccines are spoiled.
“This system … helps us coordinate when vaccines are available to notify you when and where to come to get your vaccine,” said West Virginia Gov. Jim Justice in a recent press conference about the partnership.
The administration of President Joe Biden has been promising more transparency around Covid-19 and has stepped up an ambitious plan to vaccinate 100 million people in 100 days -- saying it will "move Heaven and Earth" to get as many free shots into the arms of Americans as possible.
So far, nearly 17.4 million Americans have gotten at least one shot of the required two-shot regimen, according to the CDC.
But every dose – or batch of hundreds or thousands lost or held up – will no doubt keep many people waiting in line.
Correction: A previous version of this story misstated a county Everbridge is working with on vaccine distribution. It is in Florida.