Recently, pharmacies across the United States discarded approximately 82.1 million Covid vaccine doses, roughly 11 percent of the doses distributed. It’s a significant increase from the estimated 65 million the CDC announced wasted as of late February. In particular, two retail pharmacy chains, CVS and Walmart, were found responsible for approximately twenty-five percent of the thrown-away doses in the United States. Unfortunately, this discarding was partly due to the volume of vaccines handled.
Five other pharmacies had wasted overall doses but still sitting at higher shares. Two states were discarding more than a quarter of the quantities they received: Oklahoma and Alaska, hitting 28 percent and approximately 27 percent, respectively.
The overall level of waste is in line with World Health Organization estimates for vaccine campaigns, but public health experts suggest the waste is still alarming. As the United States indicates substantial waste, other countries still need help to receive adequate vaccine doses.
The millions of wasted vaccine doses include those expiring on pharmacy shelves before use, spoiled when freezers broke, and others tossed at the end of the day when opened vials couldn’t be accounted for. Unfortunately, the coronavirus vaccine is only available in multidose vials, meaning all doses must be used or discarded. Additionally, all COVID-19 doses come in large minimum orders, leaving pharmacies with more than they need.
Approaching COVID-19 with On-Demand Dosing
Currently, many pharmacies approach the COVID-19 vaccination program with an on-demand protocol. This means offering the shot regardless of waste. Unfortunately, wasting unused doses are part of the trade-off. With vials holding a limited shelf life, unused vaccines must be disposed of. It’s a similar challenge to other vaccines, but without the scarcity attached.
The latest CDC guidance suggests that COVID-19 vaccinations should be prioritized above everything, even if it leads to vaccine waste. As the demand for vaccinations plateaus, it often leads to open-vial wastage, particularly with multidose vials. While the CDC is working with manufacturers on developing smaller, single-dose vials for COVID-19, the expected waste from on-demand vaccination is an unfortunate component for pharmacies.
How One Company was Trying to Offset Vaccine Waste
Although large quantities of vaccines were wasted during the rollout period, one company committed to lessening the overall impact. The Dr. B website worked as a stand-by service that connected willing individuals with pharmacies offering extra doses. Individuals would register on the platform, submitting their contact information and medical history, in exchange for receiving SMS notification of available vaccine doses in their geographical area.
One Dr. B review indicates the program was a considerable success, with nearly 2.5 million people registering online. The website sent over a million SMS notifications during the pandemic, trying to offset vaccine waste in the community.
Issues with Vaccine Distribution
During initial rollouts, vaccine supply was in short supply. Strict limitations were placed on the vaccination schedules, putting a priority sequence in effect for immunocompromised, senior, and vulnerable populations. Unfortunately, these limitations caused worsening issues for individuals wanting the dose, particularly as websites became overwhelmed with appointment requests.
Senior citizens struggled with vaccine appointments as the government shifted away from traditional appointment schedules. Those without computer access were left without appointments, while others who made appointments booked duplicates to try and receive the vaccine earlier. Pharmacies faced new problems using the online system; facilities facing overages were left to fill cancelations independently, and many were trying to find willing and eligible candidates in-house.
Total Vaccine Waste Accumulation
Reports suggest that the CDC’s data on vaccine waste is likely an undercount. It fails to include four state totals – Oregon, Ohio, Maine, and Louisiana. All four of these states held technical issues with their reporting systems. Individual representatives for Oregon and Louisiana health departments indicate more than 1.7 million doses were not accounted for in the calculations. Maine Center for Disease Control and Prevention failed to show the actual numbers, stating the waste was merely negligible.
Although the initial rollout of COVID-19 vaccines was turbulent and disconnected, the development of stand-by programs successfully offset some of the waste. Despite 82.1 million COVID-19 vaccinations ending up in the trash, it only accounts for 11 percent of the doses distributed in the United States.