Coronavirus (Covid-19) and the vaccine: How getting ‘leftovers’ from retirement or nursing homes is reducing waste

Filed Under: Costs, Health plans, Patients

There has been a lot of conversation about extra doses in the Pfizer vaccine vials — meaning that the official regimen could include up to 5 doses per vial, but the vial actually has 6 or 7 doses, or maybe more. So there’s a “leftovers” issue that is causing havoc some places. (See our other vaccine coverage here. )

In several states, including New York, the extra doses were thrown away because of stringent regulations.

“Across New York State, medical providers in recent weeks had the same story: They had been forced to throw out precious vaccine doses because of difficulties finding patients who matched precisely with the state’s strict vaccination guidelines — and the steep penalties they would face had they made a mistake,” The New York Times reported on Jan. 10. The realization that these guidelines were forcing waste apparently resulted in the decision by Gov. Andrew Cuomo of New York to change procedures to avoid waste.

As this was happening, Ashish Jha, dean of the Brown University School of Public Health, appealed for better use of the extra doses.

Better use of ‘extra doses’

It turns out that better use of extra doses is happening in some places. Here’s a non-New Yorker’s experience, in western Oregon, gleaned from one of my Facebook groups.

He wrote: “I was ‘surprise’ vaccinated yesterday, so I thought I would make a PSA. My parents are in a retirement community with a subset for memory care. Because of this the whole set of seniors were vaccinated Sunday. My mother asked what happens if some residents/staff refuse and they said they could set up a wait list for others who have contact with members of the community (family, etc). She put in my name. I went towards the end of the event and waited while they checked the leftover amounts and then I was vaccinated. There were probably 8 of us that got vaccinated from the leftovers. Anyway, if any of you have relatives getting vaccinated at group events, you might check about leftovers. This was the Pfizer vaccine, so it had a short shelf life once readied for use.”

In response to a question, he added: “The funny thing was Sunday morning I was reading with outrage about a swanky retirement home in Florida diverting vaccines to wealthy people connected to the center. Two hours later I was signing up for an almost similar thing! I do feel like I am ethically in the clear but I could also see how in a perfect world they would have higher-priority people on call for such a thing. The NY law was definitely well-intentioned but with the dumb results you mention of leaving good vaccine unused.”

I asked if we could post about this and he answered, “Sure, you can refer to a ‘retirement community in western Oregon.’ When it looked like they were going to have some extra doses, one senior couple called their priest and he came in and got vaccinated.”

A supervisor at a health care facility in North Carolina chimed in: “At my facility during the phase when it was offered to staff, if there were leftover doses, they were offered to older patients who happened to be there. Otherwise the doses would have gone to waste (you cannot use them the next day)…nobody wanted that to happen.”

Later, he added: “at our facility, the daily plan is to offer the vaccine to those of the ‘current’ priority. But at end of day when those of current priority have been vaccinated, we offer leftover doses to lower priority tier who happen to be there that day. So doses are not wasted.”