The COVID-19 vaccination process is complex but very few doses have gone to waste, hospitals and clinics say

CHAPEL HILL, N.C. (WTVD) -- Despite the delays in the COVID-19 vaccine rollout and understandable frustrations, health care workers across the Triangle say very few doses have gone to waste.

The Pfizer and Moderna COVID-19 vaccines are both extremely temperature-sensitive and vials must be used within hours of being defrosted. But because so few doses are available nationwide, the Centers for Disease Control and Prevention requires all states to report whether any doses have expired or been thrown out.

Some states have reported losing hundreds of doses due to malfunctioning freezers or, in one case, a Wisconsin pharmacist who is accused of intentionally spoiling doses by taking them out of cold storage. Fortunately, central North Carolina hospitals and health departments are reporting very few wasted doses, if any at all.

UNC and Duke hospitals reported they've had to throw out about 0.2-0.3% of the number of doses administered. Cape Fear Valley Health and WakeMed said no doses have gone to waste.

A spokesperson for UNC wrote, "With all medications, there is a potential for missteps that require disposal - in a few cases there was something that went wrong in the preparation process leading up to administration." For example, the representative said, needles could be bent, a dose could be dropped or some medication could be spilled.

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And the hospital's assistant director of Pharmacy Dan Schenkat added that it's not uncommon to lose some liquid, especially in multi-dose vials like the Pfizer and Moderna vaccines.

"The more times you puncture the rubber stopper at the top of the vial, the more likely you are to create holes," Schenkat said. "If the air pressure is not equalized inside that vial, there can be vaccine liquid that leaks out of the vial."

He contrasted that complicating factor to the influenza vaccine, which often comes as pre-filled, single-dose syringes.

"We'd rather obtain a prefilled syringe where there is just a single dose," Schenkat said. "That way you don't have to worry about those expiration dates once the vial has been punctured."

Wake County reported just five doses thrown out due to user error, and clarified that no vaccines have expired due to sitting on the shelf for too long. Chatham, Johnston, Durham and Orange counties said no doses have gone to waste. Cumberland County did not respond to a request for comment.

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And all hospitals and health departments that responded said they have protocols in place to make sure few doses are spoiled -- by allowing walk-up appointments or keeping a waitlist. In a news conference Thursday, North Carolina Department of Health and Human Services Secretary Dr. Mandy Cohen said while vaccine providers should stick to the phased priority lists, it's more important not to lose any doses.

"Our guidance is don't waste any doses," Cohen said during a news conference. "If you are at the end of the day and you have two to three doses left, do not throw them away -- keep a waitlist of people where you can call someone last minute that does fit the priority waitlist. If you can't find someone on that priority list, find an arm of someone that wants it and give it out."

And that's exactly what Schenkat said is happening at the Chapel Hill hospital.

"We have processes to reach out to eligible patients to have them head over to the clinic as soon as they can to administer the doses," Schenkat said. "That's one of our main measures of success, is zero doses of waste."

It's hard to say whether the amount of waste tracked for the COVID-19 vaccine is typical of other adult vaccines, because health care workers haven't needed to track doses to the same extent. Dr. Jordan DeAngelis, the coordinator of procurement and emergency preparedness for Duke University Hospital, said in a written statement, "Duke Health has not previously tracked wastage of those common vaccines to the level of detail necessary for COVID-19 vaccine because any waste of common vaccine is relatively low impact and low incidence."

At UNC, Schenkat added that he and other health care workers are tracking the COVID vaccine more carefully because they recognize the importance of using every available dose.

"I think it is important for us to be aware of where the vaccine is going, where it's being used and ensuring that it's getting to the places that it's needed and to providers who have the ability to administer those doses to patients," Schenkat said. "We definitely do not want a vaccine just sitting around in places where it is not being used."

In an exclusive interview with ABC11, Gov. Roy Cooper said the state will begin administering at least 120,000 vaccines per week soon -- about as many doses as the state receives each week. That goal doesn't seem impossible -- according to NCDHHS, more than 147,000 first doses were administered last week.
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