When David MacMillan and a friend were checking out a grocery store in Washington, DC, on New Year’s Day, to buy some items to prepare a quiet dinner, he had an opportunity that many Americans are looking forward to: getting vaccinated against COVID-19.
The 31-year-old law student said TODAY he was passing through the pharmacy section when he noticed a pharmacist talking to a lady about whether she would like to receive the Modern COVID-19 vaccine right now. The client looked “hesitant” and “confused” and ended up refusing, said MacMillan, which was when the pharmacist turned to him and his partner.
MacMillan remembers her asking, “Hey, I have two doses of the Modern vaccine. They will expire and I will throw them out at the end of the day and close in 10 minutes. Do you want them?”
MacMillan said he was “ecstatic” at the prospect and agreed. The entire process, including paperwork and monitoring for possible adverse reactions, took 15 minutes, he estimated. He said he developed mild symptoms for a few days later, including headache and arm pain, similar to how he feels after a flu shot. He is already scheduled to receive his second dose later this month, he added.
The DC health department confirmed TODAY that the city’s policy is “zero vaccine waste. Pharmacists should follow our guidance. If doses expire due to a lack of consultation, they should administer the vaccine to anyone who wants to take it.”
Time limitations around vaccine use
Across the country, there are people like MacMillan, who happened to have access to the COVID-19 vaccine, despite not being in one of the priority groups, which are determined by the state. Most of the people who were vaccinated at this stage are health professionals.
But from northern California to Connecticut, there are reports of other individuals being vaccinated to prevent vaccines from being wasted. This may be due to storage problems or if someone does not attend your appointment. There are time restrictions around when doses should be used after opening the bottle. Moderna’s vaccine has 10 doses in a bottle, while Pfizer’s vaccine has five to six, said Judson Howe, president of Adventist Health (a faith-based health system on the West Coast and Hawaii) in Mendocino County, California, TODAY.
Storage challenges may arise because both types of vaccines must be kept cold and then brought to room temperature before administration, Dr. Bessant Parker, medical director of Adventist Health in Mendocino County, told TODAY. The Modern vaccine is viable for six months when it is stored in a freezer between -15 and -25 degrees centigrade, but it can stay at the normal temperature of the refrigerator for 30 days. When it reaches room temperature, it should be administered within 12 hours.
Pfizer, on the other hand, requires ultra-cold storage at -70 degrees Fahrenheit, but can remain in the refrigerator for five days, Parker said. After coming out of the refrigerator, it needs to be used in six hours.
On Wednesday, United States Secretary of Health and Human Services Alex Azar recommended that states start vaccinating low-priority groups if they have doses that would otherwise be in a freezer. “Faster administration can save lives now, which means that we cannot allow the perfect to be the enemy of the good,” he said.
How health officials and hospital staff are avoiding waste
Adventist Health’s Ukiah Valley Medical Center in Northern California encountered a problem with storage of the vaccine earlier this week, which led to a race to distribute 830 doses. On Monday, at around 11:30 am, Parker and Howe said they were notified that one of the facility’s freezers broke, and hundreds of doses of the Modern vaccine had been at room temperature since 2 am.
The local health department’s recommendation was to place them in the arms of as many people as possible before they expired around 2 pm, Howe said. The hospital gave the public health department 200 vaccines, called local asylums and set up a clinic near one of the largest local primary care providers, where the team had not yet been vaccinated. There were four pop-up clinics in total.
Parker estimated that more than 60% of doses ended up going to the general public. One is Leslie Banta, a 56-year-old teacher who cares for her 92-year-old mother and whose husband has a latent health problem.
“It was kind of a happy atmosphere,” she said TODAY. “People were very happy, very polite. There was no, ‘I should get the vaccine and you shouldn’t’. ” She said she expected a call from the hospital to schedule her second dose.
‘The clock is ticking’
Meanwhile, in Middletown, Connecticut, last week, 15 non-health workers, including the mayor, were vaccinated to avoid throwing out doses, said city health director Kevin Elak, TODAY.
“We didn’t really expect that if there were people who called saying they were sick or didn’t show up, we would have some vaccine left over,” he said. “Me and the director of emergency management … said, ‘OK, we have those doses left, the clock is ticking now … We don’t want to rule that out.'”
The doses were all for city officials, some of whom were in poor health, Elak said, adding that the community’s reaction was mixed, which he attributes in part to Mayor Ben Florsheim, 28, being young and healthy.
“The end result is … it’s happening across the country, where doses were being dropped … so nobody wants to see that,” said Elak. He also stressed that, for each first dose administered, the state health department automatically sends the second, so that future doses are not taken from other people. (The Moderna and Pfizer vaccines, the only two that have been authorized by the Food and Drug Administration, require two doses for total protection.)
In Nashville, Tennessee, two Subway employees were vaccinated against COVID-19 last week, when a nearby health center that vaccinated the first respondents was about to close. A nurse noticed that there were two extra doses, and no other rescuers were scheduled or present, so another nurse brought the two individuals, a local health officer told TODAY.
Similar incidents have also occurred in long-term care facilities, in addition to hospitals and other health care facilities, said a representative from the National Center for Assisted Living, an organization that represents life care providers, in a statement.
What does this mean for the public?
MacMillan, who posted a video being vaccinated on TikTok, said he received comments saying he “won the lottery” and others stating his plans to wait in supermarkets in hopes of getting the same opportunity. But at this stage, no state is vaccinating the general public, as priority is still being given to health professionals, people in long-term care facilities, the elderly and those with underlying health problems, depending on where you live.
If you are eligible at this stage to get the vaccine, but are struggling to get one, make sure you know and have signed up for notification systems when there are extra doses, either through your employer or the community. Elak said Middletown developed such a system, and Dr. Eric Cioe-Pena, an emergency physician at Northwell Health in New York, said TODAY that his hospital also has one.
Parker and Howe emphasized that when people were pressured to deliver hundreds of doses in a few hours, people would quickly return to the queue if someone in need arrived. And MacMillan had a similar mindset, he said.
“If (the pharmacist) hadn’t said, ‘Look, I only have 10 minutes’, there could have been a moment when I would have said, ‘Well, isn’t there anyone else who needs it more than I do?'” MacMillan. “I have found that if I can show that I am excited to achieve this, perhaps other people will share that enthusiasm and be less suspicious, less hesitant.”