As the COVID-19 vaccinations rollout continues, there’s still plenty of gray area surrounding protocol for leftover vaccine doses.
The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices issued guidance that urged embracing “a flexible approach” to the vaccine, especially when it was close to being unused
However, that messaging hasn't been consistently embraced, which resulted in the disposal of many doses despite the goal of vaccinating as many people as possible amidst a supply shortage.
The vaccines have a short shelf life. Once they are removed from cold storage and thawed, they must be administered within hours or they go to waste.
"Early on, the question was, 'Is the absolute red line that you don't throw a dose away? Or is the red line that you don't give it to the wrong person?'" said Dr. Matthew Zahn, medical director of the division of epidemiology for Orange County in California.
While many clinics and pharmacies were distributing the doses according to a priority list, others hesitated to give the leftover vaccines, which Zahn said was largely due to worries over their decisions being scrutinized or seen as favoritism.
In one instance, Dr. Hasan Gokal in Houston was accused of stealing vials that would have gone to waste and giving them to friends and family, USA Today noted.
Despite filing the appropriate paperwork, he was fired and charged with theft, which was later dismissed.
Some states have been more proactive about preventing vaccine waste.
New York Gov. Andrew Cuomo walked back his threat of fining providers $1 million if they vaccinated someone that wasn’t eligible in lieu of using up the extra doses.
Massachusetts, on the other hand, has a chart available online that allows you to check for leftover doses.
"In the rare instance where you have COVID-19 vaccine that will expire and you have no one in the current priority groups to be vaccinated, you can use your clinical judgment to administer the vaccine to a person in another priority group," the website notes.
However, several weeks into the vaccination program, hospitals, clinics, and vaccination centers now have protocols in place to ensure proper usage of all doses.
"The No. 1 rule is vaccine cannot go to waste," Zahn told the outlet, adding, ”Have a reasonable plan to try in good faith to reach the most eligible people, but don't waste vaccine!"
This has always been the procedure for Alan Harris, an Emergency Manager of Seminole County in Florida.
“We’ve always taken the stance that every dose is a life, so we’ve never thrown a dose away,” he said, adding that finding people eligible for the vaccine required “legwork.”
He explained that his staff would call 100 or so nursing homes and assisted living facilities every Tuesday and Friday to see if anyone needed to be vaccinated. They would then add the names to the list and call them whenever doses were left over.
Dr. Amesh Adalja, a senior scholar, Johns Hopkins Center for Health Security emphasized that it’s better to use the vaccine than have it go to waste, especially if inclement weather prevents people from making their appointments.
“Maybe you order a pizza and you vaccinate the pizza delivery person,” he said. “You need to have backup plan after backup plan.”
Recently, CVS, Walgreens, Walmart, and other retailers have rolled out a plan to use the extra supply to vaccinate eligible employees or those on the waitlist.