At a recent COVID vaccine clinic in eastern Connecticut, where the Uncas Health District was offering all three varieties of vaccine, one person requested Moderna.
That meant officials had to open a vial of the Moderna vaccine. Each vial contains 10 doses.
“We are at the point where we aren’t going to turn anybody away who wants to get vaccinated,” said Patrick McCormack, the director of the health district. “We have needed to be more creative in how we manage our doses, so we don’t waste them, and so far we have done pretty well — but it is getting harder.”
Vaccine waste has sharply increased in recent weeks as demand has dropped, officials said. As of June 16, 1,616 vaccine doses had gone to waste in Connecticut, according to the state Department of Public Health. More than 500 of those doses — nearly a third — were wasted since the end of May.
More than 4 million doses have been administered in the state since December. DPH spokesperson Maura Fitzgerald described the doses wasted as "a small price to pay."
Nationally, the Centers for Disease Control and Prevention collects data on dose wastage, though not all states were reporting their numbers to the agency, according to reporting by Kaiser Health News. The CDC has not yet responded to a CT Mirror request for state-by-state dose wastage data.
No consequences for waste
The state's numbers do not include doses shipped directly from the federal government to federally qualified health centers and pharmacies such as CVS and Walgreens.
As the state's vaccine effort has slowed significantly, the amount of waste will likely increase, something state officials anticipated in a memorandum to vaccinators in mid-May. The memo stressed the need to vaccinate as many people as possible, even if it means wasting vaccine doses.
"While we want to continue to follow best practices to use every dose possible, we do not want that to be at the expense of missing an opportunity to vaccinate every eligible person when they are ready to get vaccinated," the May 17 memo said.
"Keep in mind that there are no negative consequences for reporting waste, and it will not negatively impact future allocations. CT DPH recognizes that unused expired vaccine is a normal part of this phase of the vaccination program."
The United States and other developed nations in the West have ordered enough vaccines to vaccinate their populations many times over. Meanwhile, the World Health Organization's Covax initiative to promote global vaccine equity is suffering from supply shortages, and the virus has been ravaging South America and South Asia in recent weeks. The United States has pledged to donate 500 million doses of Pfizer to Covax by 2022, up from the 60 million originally promised.
Urgency is gone
In the early stages of the vaccine campaign, the demand was so great that officials rarely had to worry about wasting vaccine. The only reported waste was for a few that were dropped or when officials didn't realize that a vial contained six doses instead of five doses.
But back then, officials kept emergency lists of people they could call and get them to come to a clinic if there was an extra dose or two, or there would be another clinic close enough to transport it there. Now, most mass vaccination centers have been closed or curtailed to doing mostly second doses, and the emphasis is on pop-up clinics or mobile clinics designed to reach people who either cannot get to a mass vaccination site or have been reluctant to get vaccinated.
"That opportunity to fall back on other vaccine clinics is gone," McCormack said. "The sense of urgency in people to get vaccinated is gone too, so there are no more stand-by lists to call on."
Many local health directors have been using extra doses to vaccinate homebound residents who have signed up to get vaccinated through DPH's homebound program, but even that has trickled to almost nothing. The Uncas Health District, which had almost 50 homebound cases when the program was first unveiled in May, had only two this week.
Every dose matters
Earlier this week, Vernon officials held a pop-up clinic on the town green in Rockville, calling it the "you choose vaccine clinic." All three vaccines were available. They vaccinated 44 people, Town Administrator Michael Purcaro said.
"About half heard about the clinic through advertising on social media, and the other half just saw the signs as they were driving by and stopped," Purcaro said. "We've been averaging between 21 and 45 people at our pop-up clinics, but when you don't know how many people are going to show up or what vaccine they may want, you're going to have situations where you will have extra."
Purcaro said while he used to have an emergency list of senior citizens to call if there was leftover vaccine, now he has lists of private physicians in the area.
"If we see we are going to have some doses left in a vial, we'll call around to private physicians and ask them if they have anybody in mind that might want to get vaccinated," Purcaro said.
Many health departments have stopped placing weekly orders with DPH for vaccine, preferring to run with smaller supplies.
A recent decision by the FDA to expand the shelf life of the J&J vaccine by another six weeks has likely delayed any spoilage issues for now. The state is not specifically tracking how many doses are wasted because they have expired, Fitzgerald said.
DPH officials have emphasized that vaccinators need to make sure they are using the older vials before opening new ones.
Most of the state's mass vaccination sites have already been closed, or are about to be, as the focus turns to pop-up clinics and mobile clinics aimed at smaller, targeted groups.
Hartford HealthCare Chief Clinical Integration Officer James Cardon said they are getting ready to officially close the Convention Center mass vaccination site that opened in December and where more than 85,000 vaccines have been administered.
Cardon said vaccines have slowed, and they are now doing fewer than 1,000 a week across all of their vaccination sites — a total they would have done in one day at one clinic a few months ago.
Cardon said some vaccine wastage is now the "price of doing business."
"You are going to have partially used vials. It's just a consequence of where we are at now in the process," Cardon said. "There's no way around that, because we are going to give a shot to anyone who raises their hand now."
Cardon said hospital officials have been more concerned about spoilage of vaccine and have closely monitored expiration dates. He said Hartford Hospital hasn't used a lot of Johnson & Johnson.
"We have come close to a few deadlines, but we have managed to stay ahead of it so far," Cardon said.
Local health directors are also starting to shut down their weekly clinics in their communities. Many noticed several weeks ago that people were canceling appointments at their clinics because vaccines are so widely available — they can be had anywhere from a Walmart to a CVS to a car-racing venue or local fireworks show.
Stratford Director of Public Health Andrea L. Boissevain said she started noticing about a month ago that people just weren't showing up for appointments at clinics.
"Up until two clinics ago, we wasted no doses, none whatsoever," Boissevain said during a recent interview. "It's just frustrating, because I commit eight stations of volunteers, and it's tough, because I've got these people, we're at a clinic, and we're twiddling our thumbs."