CLEVELAND, Ohio – Unconfirmed rumors abound of pharmacists and other health workers discarding precious doses of COVID-19 vaccines that are about to expire or giving them to a privileged few rather than eligible folks on long waiting lists.
The vaccines are in short supply, and the waiting lists are long. That much is well documented. But are the stories of vaccines going to waste or into ineligible arms true or just products of overactive imaginations?
Cleveland.com and The Plain Dealer sought answers by reaching out to the Ohio Department of Health, the Cuyahoga County Board of Health and some private providers of vaccines. Here is what we found:
Has the county or state received reports of vaccines going to waste?
The county board reported receiving no reports of pharmacies or another vaccine providers discarding unused doses.
Via email, Ohio Health Department spokeswoman Alicia Shoults left open the possibility of unused does being discarded by stating only that the department had received no reports of “widespread avoidable vaccine waste” other than incidents already reported.
Two such incidents — one in January in which 890 doses went to waste, and another in February in which residents at five nursing homes had to be revaccinated — were related to vaccines not being stored at the right temperature, not leftover doses.
Per state guidance, providers are to contact ODH if more than 20 doses are at risk of spoiling. Cleveland.com and The Plain Dealer have asked the state to provide records showing how often this has occurred. The department has yet to comply with the request.
Why would doses be left unused?
People who have signed up for an inoculation might cancel at the last minute or simply fail to show up. Also, the vaccine is stored in vials containing multiple doses, so providers might miscalculate the number of vials needed during a vaccination session.
Why would leftovers pose a problem?
Once opened or prepared for distribution, the Moderna and Pfizer-BioNTech vaccines must be used within six hours. Doses not used within the six hours cannot be returned to storage.
What should be done with leftovers?
Ohio Department of Health suggests, but does not require, that each Ohio provider — pharmacies, health departments, health clinics or others — have a “backup recipient plan in place” to administer doses before they expire.
Under such a backup plan, providers should first give leftover vaccine to people who are currently eligible. Today, that includes adults 65 and older, teachers or others in Phase 1A and 1B groups.
If such people can’t be found in time, doses can be given to the general public, but with priority given to people with underlying medical conditions.
What kinds of backup plans are in place?
Some providers, including pharmacies such as Discount Drug Mart, use standby lists.
“At every store, we build a list of folks we know are eligible who would be willing to swing by with relatively short notice to get vaccinated,” said Jason Briscoe, director of pharmacy operations for the Ohio drug store chain. “We will proactively call patients so they can get there comfortably” before the vaccine expires.
Drug Mart also attempts to monitor vaccine appointments and usage throughout the day, so pharmacists know by mid-afternoon (rather than, say, 8 p.m.) whether doses will be left over that day, Briscoe said.
The Cuyahoga County Board of Health has no standby list for its drive-through vaccination clinics at the county fairgrounds in Berea. But spokesman Kevin Brennan said the board does have a plan for avoiding waste.
“We reduce the number of open lanes at the drive-throughs and decrease the volume of vaccine at each station an hour before the clinics end to assure that there is no waste,” Brennan said.
In the rare event doses are left over, the numbers are small and the board then contacts nearby long-term care facilities, health-care providers, or EMS workers to find eligible recipients, Brennan said.
Would the state or county consider establishing a centralized standby list?
No, neither the state nor county are considering establishing a master list that could be tapped by multiple providers.
Said Brennan at the county board: “Each provider is responsible for their own vaccine supply, so the idea of mixing all of the providers together on one wait list is not practical in terms of accountability, logistics and execution. As providers, we are best served looking after our own respective supplies.”
Standby lists are best maintained and used by individual providers, Shoults said. The state is working on a centralized vaccine sign-up system, but that’s aimed at scheduling regular appointments, not opportunities for obtaining leftover vaccine.
What options exist for people who want leftover doses?
People who want to be added to a standby list will have to contact individual providers.
Some Discount Drug Mart locations have been approached by so-called “vaccine lurkers” — people who “hang around in the parking lot in hopes of there being an extra dose,” Briscoe said. But he said he would not suggest that approach as a viable option, because it would only work in very limited circumstances.
“First, there would have to be extra doses,” he said. “Second, we would’ve had to have exhausted our entire standby list of eligible people who weren’t able to stop by. If that were the event, and there was no one [eligible] in the store, then the person in the lot would be vaccinated.”
Securing leftover vaccine also would be unlikely at MetroHealth, spokesman Mike Tobin said.
“Broadly speaking, we’re not going to give it to a guy who shows up, waiting around, if we have a patient in the hospital who we know qualifies. That’s the advantage of [administering vaccine] in a clinical setting,” Tobin said.
Is help available elsewhere?
A Facebook group, Ohio Vaccine Hunters, provides a platform for sharing tips and leads for acquiring leftover doses.
And for those who need assistance booking regular vaccine appointments, two Northeast Ohioans — dubbed the “Vaccine Queens” — are assisting older adults find openings.