The United States has released at least 15.1 million doses of Covid-19 vaccines since March 1, according to government data obtained by NBC News, an amount that is much larger than previously known and likely even a lower number.
Four national pharmacy chains reported more than a million missed doses each, according to data released Tuesday by the Centers for Disease Control and Prevention in response to a public registration request. Walgreens reported the largest amount of waste from any pharmacy, state, or vaccine provider, with nearly 2.6 million doses lost. CVS reported 2.3 million wasted doses, while Walmart reported 1.6 million and Rite Aid reported 1.1 million.
Data released by the CDC is self-reported by pharmacies, states, and other vaccine providers. It is not exhaustive (some states and federal providers are missing) and does not include the reason why the doses had to be thrown away. The number of rejected doses remains a small fraction of the total vaccines administered in the US
In general, there are several reasons why vaccination sites may have to mark doses as wasted, from a cracked vial or an error in diluting the vaccine to a freezer malfunction to more doses in a bottle that people who want them. A waste report can also occur when a vial contains fewer doses than it should.
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Missed dose data arrive as the most contagious delta variant spreads rapidly across the United States, adding new urgency to the effort to vaccinate as many people as possible and pushing a plan to begin offering booster shots to that were already vaccinated, even many nations around the world have vaccinated few, if any, of their residents.
“It is really tragic that we have a situation where vaccines are wasted while many African countries have not had even 5% of their populations vaccinated,” said Sharifah Sekalala, an associate professor of global health law at the University of England. of Warwick, who studies inequalities in infectious diseases.
“Much of the southern world is not vaccinated. The African continent is still below 10 percent, and that’s just a huge inequality and it’s really problematic.”
CDC spokeswoman Kristen Nordlund said in an email that the share of wasted Covid vaccines “remains extremely low, demonstrating the strong partnership between the federal government, jurisdictions and vaccine providers to vaccinate so many people.” as much as possible while reducing the waste of the vaccine system. “
Nordland added: “As access to the Covid-19 vaccine has increased, it is important that providers do not miss any opportunity to vaccinate all eligible people who come to vaccine clinics, even if it can increase the probability of leaving unused doses in a vial. “
A CVS spokesman noted a similar statement, writing in an email: “While we regret having to remove any vaccine, we are extremely proud of our store employees who have helped administer more than 30 million doses. “When given the option of saving a life or slightly improving our waste figures, we will always choose the former.”
Walgreens, Walmart and Rite Aid did not comment immediately. “Our goal has always been to ensure that all doses of vaccine are used,” Walgreens spokesman Kris Lathan told Kaiser Health News in May.
The number of doses destroyed is a small fraction of the more than 438 million doses that were distributed in the country on Tuesday and the 111.7 million additional doses that the US had given to other countries on 3 August.
Demand for vaccines in the United States increased in August as cases and hospitalizations increased due to the delta variant. However, the United States wasted at least 3.8 million doses in August alone, according to the data.
States, pharmacies and other vaccine providers also reported at least 4.4 million wasted doses to the CDC in June and 4.7 million in July, more than in March, April and May combined.
No state health department came close to the number of doses wasted by pharmacy chains, but four reported more than 200,000 wasted doses each. Texas led the state with vaccine residue reports, with 517,746 doses missed, North Carolina reported 285,126, Pennsylvania reported 244,214 and Oklahoma reported 226,163.
Lara Anton, a spokeswoman for the Texas State Department of Health Services, said the state “instructed vaccine providers to prioritize vaccinators when they go in to get vaccinated instead of waiting until they find enough. people to use all doses of the bottle before opening it, “which can cause dose wastage. Anton also mentioned the extreme weather in May as a contribution to the number of Texas wastes.
Representatives from the North Carolina, Pennsylvania and Oklahoma health departments did not comment immediately.
Last month, the Food and Drug Administration authorized booster shots for immunocompromised people because their bodies may not respond to the initial vaccine regimen. The Biden administration has also announced a plan, pending the signing of the FDA and CDC, to offer booster shots to all Americans eight months after its last dose in response to declining immunity tests.
These moves sparked a debate over whether it was moral to offer Americans additional protection when so many people around the world have not received a single vaccine against Covid.
But new data showed that the United States has wasted far more doses of vaccine than many poorer countries for its entire population. For example, the country of Georgia, a coronavirus hotspot, has administered only 1.1 million doses of vaccine for its population of 4.9 million. Nepal, which has been devastated by the delta variant, has administered only 9.7 million doses for its population of 30.4 million.
“It’s an equity issue,” said Tim Doran, a professor of health policy at York University in the UK. “You have a very rich country with good access to vaccines that basically throw out the vaccine and a lot of vaccines, and you have other countries and other communities in those countries that would really require it, that had to wait and don’t have access to the vaccine. and that makes them susceptible while they are waiting for the vaccine. “
Sekalala said the U.S. wasting so many doses was “inevitable by the model” that rich countries bought large quantities of vaccines for themselves, thinking only of giving them later to poorer countries.
“It’s a failure of the current system where rich countries buy their batches of individual vaccines and then have to think about what will happen if they don’t use them,” he said. “This led to over-buying, as people buy supplies they didn’t need or were unable to use.”
One of the factors that contributes to the waste of vaccines is the way they are packaged. Most vaccines for other diseases are given in single-dose vials. But, depending on the equipment used to extract a dose, Moderna’s Covid vaccine has up to 15 doses in one vial, while Pfizer has made up to six and Johnson & Johnson has made five. .
Once a vial is punctured (for example, if a customer requests the vaccine at a retail pharmacy), the watch begins to dial. One vial of Moderna vaccine should be discarded 12 hours after being punctured, while those of Pfizer and Johnson & Johnson should be discarded within six hours.
The high number of doses in each vial and the relatively short time to use a vial once it has been drilled probably contributed to the unused doses being lost.
The data released on Tuesday is more detailed and complete than data released by the CDC in April, when an investigation by Kaiser Health News found that the country wasted nearly 200,000 doses of Covid vaccine from December 2020 to March 2021.
An independent New York Times investigation found approximately one million doses lost in 10 states from December to July.
More detailed data suggests that the CDC now has a better picture of how much is being wasted and where it was done before than in the vaccination program. However, seven states of the recently published data are missing: Arkansas, Connecticut, Louisiana, Maine, Nevada, Ohio, and Oregon.
Another state, Michigan, has reported only 12 missed doses at the CDC since March 1.
Several vaccine providers reported the loss of thousands of doses to the CDC in a single report. But overall, recently released data show that vaccine waste was a slow, steady drip rather than a flood; the most common report of the data was only four doses missed at a time.
Also missing from CDC data are doses wasted by federal agencies administering vaccines, including the Department of Defense, the Prisons Office, the Veterans Health Administration and the Indian Health Service.
More data on vaccine waste is available at Tiberius, a system administered by the Department of Health and Human Services, but officials have not yet released it. The data released Tuesday came from the CDC vaccine tracking system, or VTrckS, which extracts data from state and local vaccination records.