Nearly 100 vaccine providers in North Carolina reported discarding COVID-19 doses, according to records the ABC11 I-Team obtained from the North Carolina Department of Health and Human Services (NCDHHS).
Of the 1.8 million doses the state has administered, 2,346 doses (0.1%) were deemed unusable as of Feb. 18.
Vaccine providers attribute the waste to shipping issues, lack of patients, refrigeration problems and user errors.
The I-Team previously reported around 0.2-0.3% of doses from providers around the Triangle went to waste.
The newly-obtained data shows a better picture of this waste statewide.
"As with any vaccine distribution, it is anticipated that there will be minor accidents resulting in vaccine being discarded due to expiration or broken vials, but health care providers have been working hard to ensure all vaccines are used and stored properly," a NCDHHS spokesperson wrote to the I-Team in an email.
NCDHHS said it has not received any reports of significant batches being lost.
COVID-19 vaccine providers are required to report all doses that are "unused, spoiled, expired or wasted," due to the limited supply nationwide.
"Over the course of any large-scale vaccination effort, a small number of doses may be lost inadvertently, such as a dropped syringe on floor, however, data on wasted vaccine is an essential metric for state and federal health agencies storage and handling procedures to maintain COVID-19 vaccine cold chain and minimize the likelihood of vaccine loss or damage during shipment," an NCDHHS spokesperson wrote in an email.
Health care officials also said bent needles and spillage are other reasons for discarded doses.
Doses have also had to get thrown out if they reach unsafe temperatures. Both the Moderna and Pfizer vaccine have specific storage and handling instructions.
One-hundred doses delivered to the Select Specialty Hospital in Durham had to be discarded due to shipping issues. A spokesperson explained a delay in transit led to the proper temperature for the vaccine not getting maintained.
Issues with shipped doses also accounted for many of the 335 discarded doses reported by the Lee County Health Department.
"Using guidance provided by DHHS and vaccine manufacturers to protect the health and safety of our patients, our staff will dispose of unusable vaccine that was damaged during shipment (i.e. damaged packaging) and those where vaccine integrity is in question (i.e. temperature control concerns). While this may be referred to as 'wasted' vaccine, in truth it is unusable vaccine that was removed from our supply," spokesperson Heath Cain explained in an email to the I-Team.
The Lee County Health Department reported the highest number of unusable doses and accounted for 14% of the state's overall waste. Providers in the county have only received 8,750 first doses of the vaccine so the waste is more significant than in a county like Wake County where providers have received more than 104,000 first doses but only reported 72 wasted vaccines.
Cain said 50 doses were discarded due to a lack of patients at one of the county's drive-thru clinics.
"Most of these occurred at our early clinics and each week, as we gained more experience administering vaccine and planning for clinics, we have drastically reduced (almost eliminated) the number of unused doses at our clinics that we must dispose of due to lack of patients on-site to receive the vaccine," Cain said.
The Vidant Edgecombe Hospital reported the 2nd highest number of discarded doses at 213. A spokesperson for the hospital said these doses were caused by a mechanical failure that led to a refrigeration issue overnight.
"The hospital team made the appropriate decision not to use the doses and the mechanical issue was fixed. As per required safety protocols, the team disposed of the doses and reported the waste to the appropriate agencies," a spokesperson wrote in a statement.
Cumberland County and Franklin County health departments also each reported around 150 discarded doses.
Dr. Jennifer Green, the Cumberland County health director, said the county has only wasted 95 doses because 59 were mislabeled due the to state's reporting system.
She said a majority of the 95 were wasted during the first week of vaccinations.
"Once we learned, hey, we can vaccinate outside of the priority group instead of throwing the dose away, we immediately started implementing that practice and since then we have very minimal doses that were unusable because we didn't have an arm to put it in."
Green said since then protocols such as not opening multi-dose vials too soon and administering extra doses have reduced waste.
"We've gotten better, we've improved our processes and we have very limited waste now because we've looked to see what other providers are doing and we've gotten best practices from them. We are always going to have a needle break or a syringe leaks because we are doing it in mass," Green said. The county has also been able to extract 1,000 extra doses from the vials.
State data shows Bladen County discarded 100 doses but health director Terri Duncan said the department has only wasted one.
Thirty-five counties had no providers report any waste including Vance, Northampton, Warren and Alamance County.
Both the state and individual providers are working to not throw out extra doses at the end of the day. NCDHHS currently advises providers to have an 'on call' list if there are extra doses at the end of an event.
"If a provider has extra doses in a vial but no one in the current priority groups to vaccinate, they should vaccinate someone who is not currently prioritized instead of wasting doses," wrote an NCDHHS spokesperson in an email.
Cain in Lee County said their department has made changes to clinics, dose preparation and on-call lists to help eliminate the number of unused doses going forward.
"We will do everything we can to limit waste and improve vaccine access and delivery but we will do so while maintaining the integrity of the vaccine we are administering. Our priority remains the health and safety of our citizens," Cain wrote.
"We are administering in mass volume and in often a very short and a very quick period of time and so we are relying on some of the policies and procedures to make sure we are limiting that and we are continuing to implement those practices so we get better all the time but we want to make sure if we have a dose available that it goes in the arm and we want to make sure that we have minimal unusable doses the best we can," Green said.