Pharmacies supposed to administer many of the shots are concerned over waste, and state and local health officials say they need more money and instructions from the federal government. The Federal Health Department says states have what they need and that the government will stop any bottlenecks that arise.
“We really don’t want to lose a drop of this stuff, so it’s a problem. And I don’t have all the answers on how we’re going to do it,” said Paul Cieslak, Oregon’s medical director for communicable diseases and vaccinations.
If the vaccine is approved in an emergency, it is expected that it will be given to healthcare workers and the elderly first, further complicating planning efforts.
Most of the concerns stem from the Covid-19 vaccine requirements Pfizer submitted for review by the FDA on Friday. It must be stored in extremely cold conditions and comes in specially designed pizza-shaped boxes containing at least 975 cans in 195 glass vials. Once a vial is thawed and diluted to make five shots, health workers are in a real situation of using or losing it: when not enough people are ready for the vial Shots within six hours, spoil the vaccine and slow down efforts to root out hot spots and save lives.
“That won’t be acceptable,” said Douglas Hoey, CEO of the National Community Pharmacists Association. “Especially early it will be practically liquid gold.”
Some wastes are inevitable in any large-scale vaccination program. This is not the seasonal flu, however: all Covid-19 vaccines cleared for use end up during a devastating global pandemic that nearly killed 1.4 million people worldwide – over a quarter of a million in the US – with no sign of stopping. With analysts predicting that vaccinating all Americans could take months, minimizing waste will be vital.
The earliest vaccinations will focus on hospitals, federal health officials say. Even they might struggle to minimize the number of tainted doses when vaccinating employees. But the waste problem will They get bigger as pharmacies are gradually added – especially in rural areas where fewer people live.
Maryland health officials told the Centers for Disease Control and Prevention that up to 5 percent of the vaccine the state receives could spoil and go unused.
Some rural counties may not be able to use 975 cans on their own, said Kurt Seetoo, who heads the State Department of Health’s Center for Immunization. Maryland is considering creating regional clinics that will bring high priority groups from different rural counties together to vaccinate simultaneously.
HHS Secretary Alex Azar told Sirius XM on Friday that Pfizer’s more demanding storage requirements make it better suited for larger institutions like hospitals and large retail pharmacies. Another Covid-19 vaccine maker, Moderna, is about to apply to the FDA for emergency clearance for its shot, which can be stored in the refrigerator for up to 30 days and at room temperature for up to 12 hours.
Earlier this week, General Gustave Perna, who heads Operation Warp Speed, the Trump administration initiative tasked with bringing a vaccine to market, said CVS and Walgreens know how to do it and that his team is working with states has to “make sure no vaccine is wasted. “
Paul Offit, vaccine researcher at Philadelphia Children’s Hospital and a member of the panel of experts advising the FDA on Covid-19 vaccines, told reporters Friday that he was “very concerned” about the potential for doses of Pfizer’s vaccine to be wasted if authorized is.
“It will be very difficult, I think there will be a steep learning curve here,” said Offit. “I think there will be a lot of waste and I think we will find out over time. There will be a lot of stumbling. … You have six hours after the recovery, which is unprecedented. “
In Oregon, the state can contract with emergency medical services to drive the vaccine around and distribute it to remote areas in an attempt to avoid leftover shots.
And North Dakota wants to repackage the vaccine in boxes in smaller quantities while encouraging vendors to quickly identify people in the next priority group so they can get a shot if there is any left vaccine. The state also urges facilities to pre-register patients to ensure they don’t have to throw a vaccine. His vaccination schedule recognizes that doing so could delay distribution for a day, but it is necessary to save valuable vials. Pfizer says it is working on a smaller package size, but it won’t be ready until early next year and it’s unclear whether it will resolve the need to deliver at least five shots in hours.
The disparate plans underscore the concern public health experts have long expressed about the hands-off approach the Trump administration has maintained throughout the pandemic. This also applies to the final leg of the vaccine race, which the president has made the centerpiece of his coronavirus response.
“There’s a tremendous leadership vacuum,” said Georges Benjamin, executive director of the American Public Health Association.
Meanwhile, the Trump administration is refusing to share its planning with President-elect Joe Biden’s transition team, who on Wednesday said the lack of access could hamper vaccine distribution. Instead, Biden’s team was in contact with Pfizer and other drug companies; A Pfizer spokesman declined to provide details of the communication.
“There is no excuse not to reveal the data and start planning,” Biden said during a press conference Thursday. “If we don’t have access to all of this data, we’ll be behind the eight ball for at least a month or more.” And that is life. “
Azar denied the claim on CBS’s “This Morning” Friday, saying it was “dead wrong”.