By Rolfe Winkler
David MacMillan lucked into a dose of Moderna Inc.'s Covid
vaccine late on New Year's Day. While grocery shopping at Giant
Food in Washington, D.C., the 31-year-old paralegal passed by the
in-store pharmacist who was scrambling to find takers for two doses
after a pair of health-care workers missed their appointments. The
store was scheduled to close in 10 minutes and the thawed doses
would have to be thrown out.
Two of the store's associates and another customer had already
declined the shots. Mr. MacMillan and his 25-year-old friend
happily volunteered. "I was thrilled," said Mr. MacMillan, whose
post on TikTok about the experience went viral. "It's like being
told you won the lottery."
As scarce supplies slowly roll out to the public, there is
sometimes extra vaccine. Many vials contain a dose or two more than
expected. Some people miss appointments and their shots have to be
given away so vaccine doesn't go to waste. Some vaccination sites
are ready to give shots to new groups of people or want to move
vaccine across county or state lines to where people are waiting
for it, only to be held up by local authorities. Occasionally a
freezer breaks prompting a race to get shots into arms.
It's an extra layer of complexity for vaccination sites as they
struggle with the logistics of the largest vaccination campaign in
history. The vaccine from Pfizer Inc. is stored below minus 76
degrees Fahrenheit and the Moderna vaccine below 5 degrees
Fahrenheit. Once thawed neither can be put back in a freezer.
The U.S. Health and Human Services Department said Tuesday that
all people over 65 and anyone with pre-existing conditions should
be eligible for the shot, releasing millions of doses that it has
held back for second doses for health-care workers. The expanded
eligibility will help vaccination sites find willing takers. At the
same time some locations may not be able to administer shots as
quickly as they would like due to staffing issues amid a winter
surge in Covid-19 cases. And some may still face the problem of
waste at the end of each day.
When hospitals, pharmacies and other facilities received their
first shipments of Pfizer's vaccine a month ago, many quickly
noticed that vials expected to have five doses each, sometimes had
six or even seven. After some facilities threw out extra doses, the
Food and Drug Administration said last month on Twitter that sites
should use them. A week later, Moderna's 10-dose vials began
shipping, sometimes with enough vaccine for 11 shots. Health-care
workers have been instructed not to let those extra doses go to
The unexpected blessing was a logistics headache, said Amy
Compton-Phillips, chief clinical officer at multistate hospital
system Providence. The Pfizer injection kits sent to hospitals had
only five syringes and five needles. "So for the sixth or seventh
dose, there's no syringe or needle," Dr. Compton-Phillips said.
Those essentials are in short supply, she said, "so we are turning
over rocks trying to give people those doses."
A spokesman for McKesson Corp., which puts together vaccine kits
for the government, said that some shipments of Pfizer vaccine
included high-efficiency syringes, enabling extraction of
additional doses from vials. The government procured the syringes
for the kits, he said, and some aren't the more efficient type. He
said McKesson is working with the U.S. government "to create kits
which support extraction of the additional doses."
An HHS spokesman said the government is working to augment
vaccine kits with a variety of syringes and needles, including
more-efficient ones so an extra dose can be extracted from each
Pfizer vial. Neither McKesson nor HHS commented on extra doses
found in Moderna vaccine vials.
A spokesman for Giant Food said in a statement that the District
of Columbia's public health department has directed the grocery
chain to find willing takers for doses set to expire. Its
pharmacists prioritize store associates for extra vaccine, then
people over 65, before offering it to anyone over 18, he said.
Mount Sinai Health System in New York City keeps a list of its
health-care workers approved to get the vaccine so it can summon
them for a shot if there is extra that might be thrown out, said
Susan Mashni, its chief pharmacy officer.
Providence could vaccinate faster if local regulations were more
consistent and more flexible, said Ali Santore, the executive in
charge of government affairs for the hospital system. In Washington
state, it has largely completed vaccinating the first tier of
eligible people and has vaccine to give to people in the next tier,
she said, yet the state won't permit that additional distribution
until Jan. 18.
In Southern California, she said Orange County now allows all
those over 65 to be vaccinated, while next door Los Angeles County
doesn't. "This creates inequities," she said Wednesday. Later in
the day, the state of California said everyone over 65 is now
Providence could also get shots into arms more quickly if it
could move vaccine doses across county or state lines, but that
generally hasn't been allowed, Ms. Santore said.
Executives at Adventist Health Ukiah Valley hospital in
California were sitting down to their morning meeting at the start
of last week when a facilities director came in to tell them a
freezer holding Moderna's vaccine had failed at 2 a.m. The 830
doses inside would be trashed unless they could find people to
vaccinate before 2 p.m.
The hospital, which is located in Mendocino County, moved
quickly, blasting employees with a text message and instructing
them to spread the word, said Judson Howe, its president. The
hospital gave some doses to county health officials, who rushed
them to local corrections officers and other at-risk workers.
Hundreds lined up at pop-up vaccine sites. Ultimately all shots
On Friday, Mendocino County received another shipment of 975
Pfizer doses, which County Health Commissioner Andy Coren said
would be used at vaccination centers starting Tuesday. Dr. Coren
said in a rural county like Mendocino it takes time to reach
everyone eligible for early doses, including members of the Latino
community, who he said make up a third of the local population but
have suffered two-thirds of its Covid-19 cases.
--Sarah Krouse and Jared S. Hopkins contributed to this
Write to Rolfe Winkler at email@example.com
(END) Dow Jones Newswires
January 13, 2021 15:39 ET (20:39 GMT)
Copyright (c) 2021 Dow Jones & Company, Inc.