Since the vaccines began to be rolled out, we have heard too many stories of discarding large amounts of doses. Some cases have been due to the intentional malice of bad actors and addicts to conspiracy theory. Others have been caused by failures in refrigeration equipment or simply by a simple human error. But it turns out that every week there is an even greater number of doses in the trash without any of these things happening. NBC News released a harrowing report this week revealing that health care workers are increasingly dismayed by the high number of doses that end up being discarded while people are still waiting in line to receive a punch. The reason is that when they go down near the end of a road, they are not allowed to use a process known as “grouping” to avoid wasting the precious liquid. The result is that for every shipment of 80 vials, forty complete doses of the vaccine end up in the trash. I blame the FDA.
Pharmacists at Inova Health, one of the largest hospital systems in the Washington, DC area, say they began noticing significant amounts of leftover vaccine in almost every vial, even after using the sixth additional dose in the Pfizer vials. But because of FDA regulations, they are forced to release any additional vaccines.
“It’s heartbreaking for us,” Massiah-White said. “We’ve had several team members rotate around here and at least someone says every day,‘ Why can’t we group the waste? “”
Inova pharmacists performed an experiment taking 100 vials with residual vaccine. Eighty of them were left with significant amounts. Pharmacists found that with the remaining vaccine in the 80 vials, they could make an additional 40 full doses. This meant that on a typical vaccination day, when the hospital usually gives more than 4,000 vaccines, an additional 400 vaccines could be given with the same supply.
Health workers say the grouping is done all the time, including flu vaccines. It is also done with chemotherapy drugs and antibiotics. When a vial does not have enough medicine left for a full dose, it is combined with the remains of one or more vials until it accumulates enough to get a full dose. The vials do not contain exactly the same amount and pharmaceutical companies always put enough in one vial to ensure that the indicated number of doses is available, plus a little more. Apparently, it can add up quickly and can cause pods to make 10% more patients a day than they can currently do.
But the FDA claims that these coronavirus vaccines cannot be grouped because neither Moderna nor Pfizer products contain preservatives designed to inhibit the microbial growth of germs or bacteria. Sharing, they say, would create a risk of unrelated infections as a result of vaccination. But pharmacy experts with whom NBC News spoke argue this point and say the risk of contamination in clinical conditions is low. In addition, the risk is offset by the advantage of increasing the number of doses in such a significant volume.
I’m not a doctor, but I’m not sure which side I believe most in this issue. I would be willing to get a way to significantly increase supply in an economical and timely manner. But I’m a little shocked by the idea of going to get vaccinated and coming out with some kind of blood infection that could turn out to be worse than COVID. Or maybe I just react too much. It’s hard to say. I guess a better question that is not addressed in the related report would be why no preservatives are added to the Pfizer and Moderna vaccines if it is possible to introduce it into an influenza vaccine. Is it because they developed and tested the vaccines so quickly that there was no time to do it or is there something unique about these vaccines that would not allow it to be done? If it is the first, perhaps the next generation of vaccines can be grouped. But if not, we rebalance the risk of contamination with the value of a more robust supply.