David MacMillan was lucky with a dose of Moderna Inc.’s
Covid vaccine at the end of New Year’s Day. While shopping at Giant Food in Washington, DC, the 31-year-old paralegal passed the pharmacist at the store who was struggling to find buyers for two doses after two health professionals missed appointments. The store was scheduled to close in 10 minutes and the thawed doses would have to be thrown away.
Two of the store’s associates and another customer had already refused doses. Mr. MacMillan and his 25-year-old friend happily volunteered. “I was thrilled,” said MacMillan, whose TikTok post about the experience went viral. “It’s like hearing that you won the lottery.”
As scarce supplies slowly reach the public, there is sometimes an extra vaccine. The vials have one or two extra doses if the vaccine kits have more efficient syringes. Some people miss appointments and their vaccines need to be administered so that the vaccine is not wasted. Some vaccination sites are ready to give injections to new groups of people or want to take the vaccine between counties or states to where people are waiting, only to be detained by local authorities. Occasionally, a freezer breaks, leading a race to shoot in the arms.
Medical workers are preparing to administer vaccines at a site in Plant City, Florida, on Wednesday.
Photograph:
octavio jones / Reuters
It’s an extra layer of complexity for vaccination sites as they struggle with the logistics of the largest vaccination campaign in history. The Pfizer vaccine Inc.
it is stored below minus 76 degrees Fahrenheit and the Modern vaccine below 5 degrees Fahrenheit. After thawing, neither can be put back in the freezer.
The US Department of Health and Human Services said on Tuesday that everyone over 65 and anyone with pre-existing illnesses should be eligible for the injection, releasing millions of doses that were withheld for the second doses to Health professionals. The expanded eligibility will help vaccination sites find willing candidates. At the same time, some sites may not be able to administer the injections as quickly as they would like due to staffing problems amid a winter peak in Covid-19 cases. And some may still face the problem of waste at the end of each day.
When hospitals, pharmacies and other facilities received their first shipments of vaccines from Pfizer a month ago, many quickly noted that the vials should have five doses each, sometimes six or even seven. After some facilities ruled out extra doses, the Food and Drug Administration said last month on Twitter that websites should use them. A week later, the 10-dose vials of Moderna started shipping, sometimes with enough vaccine for 11 injections. Health professionals were instructed not to waste these extra doses.
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The unexpected blessing was a logistical headache, said Amy Compton-Phillips, clinical director of the multi-state hospital system in Providence. The Pfizer injection kits sent to hospitals had only five syringes and five needles. “So for the sixth or seventh dose, there is no syringe or needle,” said Dr. Compton-Phillips. These essential products are scarce, she said, “so we are rolling stones to give people these doses.”
A spokesman for McKesson Corp.
, which brings together vaccine kits for the government, said some Pfizer vaccine shipments included high-efficiency syringes, allowing the extraction of additional doses from vials. The government purchased the syringes for the kits, he said, and some are not the most efficient type. He said McKesson is working with the US government “to create kits that support the extraction of additional doses”.
An HHS spokesman said the government is working to augment vaccine kits with a variety of syringes and needles, including more efficient ones, so that an extra dose can be extracted from each bottle of Pfizer. Neither McKesson nor HHS commented on the extra doses found in Modern vaccine bottles.
A Giant Food spokesman said in a statement that the District of Columbia public health department instructed the supermarket chain to find willing buyers for the set doses to expire. Their pharmacists prioritize salespeople for the extra vaccine, then people over 65, before offering it to anyone over 18, he said.
The Mount Sinai Health System in New York City maintains a list of its approved healthcare professionals to receive the vaccine, so you can call them in for an injection if there are any extras that can be discarded, said Susan Mashni, your pharmacy director.
Providence could vaccinate faster if local regulations were more consistent and flexible, said Ali Santore, the executive responsible for government affairs for the hospital system. In Washington state, most first-tier vaccinations of eligible people have been completed and have a vaccine to give to people at the next tier, she said, but the state will not allow this additional distribution until January 18.
A vaccination line at Adventist Health Ukiah Valley hospital in Mendocino County, California, last week.
Photograph:
Jethro Bowers / Associated Press
In Southern California, she said Orange County now allows all people over 65 to be vaccinated, while Los Angeles County next door does not. “It creates inequality,” she said on Wednesday. At the end of the day, the state of California said that everyone over 65 is now eligible; but Ms. Santore said the vaccine distribution in the state remains a county-by-county process and the guideline has not yet been formally communicated.
Providence could also fire gun shots more quickly if it could distribute doses of vaccine across counties or states, but that is generally not allowed, said Santore.
Executives at Adventist Health Ukiah Valley Hospital in California were seated for their morning meeting earlier last week when a facility director came to tell them that a freezer containing Moderna’s vaccine had failed at 2 am. The 830 doses inside would be destroyed, unless they could find people to vaccinate before 2pm
The hospital, which is located in Mendocino County, has changed quickly, sending a text message to employees and instructing them to spread the word, said Judson Howe, its president. The hospital gave some doses to county health officials, who sent them to local prison officers and other workers at risk. Hundreds lined up at emerging vaccine sites. In the end, all shots were administered.
On Friday, Mendocino County received another shipment of 975 doses from Pfizer, which County Health Commissioner Andy Coren said would be used in vaccination centers starting on Tuesday. Dr. Coren said that in a rural county like Mendocino it takes time to reach all those eligible for the first doses, including members of the Latin community, who he said make up a third of the local population, but have suffered two-thirds of their Covid-19 cases .
—Sarah Krouse and Jared S. Hopkins contributed to this article.
Write to Rolfe Winkler at [email protected]
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