Why Are So Many COVID-19 Vaccines Going to Waste?

The COVID-19 vaccine has been described as “liquid gold”, so why is so much of it ending up in the trash?

It’s not exactly clear how many doses are going to waste across the country, but scheduling issues, strict storage requirements, and regulatory hurdles are making it difficult to get the shot in people’s arms before they expire. In one case, the Ohio Department of Health had to suspend a provider after 900 doses of the drug failed to reach nursing home residents in time.

For some providers, it becomes a race against the clock once they open the freezer.

Ultra-cold Temperatures

Both the Moderna and Pfizer vaccines must be kept below freezing for the drug to remain effective. The one from Pfizer can be particularly difficult to distribute and administer. The freezer can only be opened twice before the drugs start to expire, so time is of the essence.

Amesh Adalja, an infectious disease specialist at Johns Hopkins University, noted, “There was nervousness amongst people, if they weren’t able to vaccinate everybody that day and they had leftovers, that they didn’t know what to do with those doses,” during an interview with NPR.

To avoid spoilage, facilities need everything to go right. That means having people show for their appointments on time before the drugs get too warm. Even the smallest delay could render a few samples ineffective.

Washington State Hospital Association CEO Cassie Sauer says it’s usually only a few samples at a time, but all that waste starts to add up over time. “If you’re doing 500, 700 doses a day, to end up at the end of the day with three leftovers, you know, we’d like there to be zero but that’s a hard ratio to hit,” she said earlier this month.

Regulatory Issues

When the vaccine was first being administered, states were told to reserve shots for healthcare workers and nursing home residents. Some states have since expanded the eligible population, which gives more people a chance to get vaccinated. If providers deviate from these guidelines, they could face a fine, lose their licenses, or even face criminal charges.

In New York, Gov. Andrew Cuomo threatened to impose heavy fines and criminal penalties on anyone caught doling out the vaccine outside of these guidelines.

These rules were meant to ensure priority and high-risk individuals could get a vaccine, but the plan may have backfired.  

“If people are dogmatically sticking to these priority groups…I think that’s the wrong approach,” Adalja said.

Providers may have no choice but to throw the vaccines in the garbage if they aren’t allowed to vaccinate someone outside the eligible population.

Adalja says it’s common for people to miss their appointments. Seniors may have trouble securing a ride. Long lines and winter commutes can also be prohibitive for some individuals. That’s why many clinics and facilities are double-booking appointments, so there’s always someone there to get a shot.

Change for the Better

As we get further into the vaccination process, providers are finding ways to circumvent these issues.

Several states have since eased restrictions so providers don’t have to worry about losing their jobs if they have to vaccinate someone who’s technically ineligible.

“They’re really getting flexible and trying to stretch the supply as best they can and avoid any kind of waste, because a vaccine in an arm is always going to be better than a vaccine in a trash can,” Adalja said.

We’ve also seen the rise of what are known as “vaccine scavengers” – people who wait around clinics and facilities hoping that someone doesn’t show up for their shot.

Adalja says, “They’re actually helping to avoid waste because they’re ready to go.”

In other places, providers are putting together mobile vaccine clinics that will go from door-to-door vaccinating eligible individuals who may have trouble getting to the clinic in person.

These issues may resolve themselves as more people become eligible for the vaccine. However, some folks may need to be on stand-by if someone doesn’t show up for their appointment. However, many people will also have a day job, which could make scheduling an issue in some areas.

If a facility cancels the appointment at the last minute, overscheduling might be to blame, so try to be patient as providers continue navigating one of the biggest public health campaigns in history.