ARI SHAPIRO, HOST:
COVID-19 vaccines are one of the nation's most precious commodities, and yet doses are going to waste - defrosted, then thrown out before being injected. A vaccine provider in Ohio, for example, allowed nearly 900 doses to spoil before they got to nursing home residents. Amesh Adalja of Johns Hopkins University says it's unclear how many doses have been thrown out, but I asked him why doses are going to waste at all.
AMESH ADALJA: Well, you have to remember that these vaccines, especially the Pfizer vaccine, have very stringent storage requirements. And when you thaw them, you've got to use them or lose them. And early on in the vaccination program, there was a strong effort to try and stick to priority groups, staying with Priority Group 1A, which included health care workers and residents of nursing homes. And there was nervousness amongst people if they weren't able to vaccinate everybody that day and they had leftovers that they didn't know what to do with those doses. For example, you had the governor of New York saying that if you vaccinate outside the priority group, I'm not only going to fine you; I'm going to take your license.
ADALJA: I think that's starting to end now. And people do have these friends and family lists to avoid vaccine going into the trash can, but that wasn't the case in the beginning.
SHAPIRO: Sounds like you're saying there's a learning curve, where maybe the distribution is becoming more efficient with less waste as hospitals and pharmacies figure out how to do this.
ADALJA: I do think it's becoming more efficient, and it has less to do with the distribution but them becoming innovative, saying we've got a waiting list of people. So if we've got leftovers that are going to end up in the trash can, who are your friends and family that you can call quickly? And we know that there are people that kind of mull around vaccination sites just waiting for this possibility. So those kind of vaccine scavengers - I think is a good word for them - they're actually helping to avoid waste because they're ready to go. And in Oregon, for example, some vaccinators got stuck in a snowstorm and just started randomly vaccinating people in cars, which is a good thing to do.
SHAPIRO: Right. I saw that. NPR obtained an email from the Dana-Farber Cancer Institute in Boston telling staff that far too many people were failing to show up for their shots and as a result, quote, "prepared doses may be wasted." How common is that specific problem, that people just don't show up? And what are hospitals and other institutions doing to avoid it?
ADALJA: It is very common. I know some of my friends have been in line to get their vaccine and saying there's tons of no-shows here today. What I think hospitals are doing is they're sending reminders to people to remind them of their dose, and they're also coming up with waiting lists and have a secondary list that they can run off of. For example, one hospital in my hometown outside of Pittsburgh, when they couldn't do Phase 1A, when they finished those people for the day, they would start calling up the ambulance services and saying, do you have any paramedics or EMTs that need vaccinated? So that's what hospitals are doing. And they're really getting flexible and trying to stretch the supply as best they can and avoid any kind of waste because a vaccine in an arm is always going to be better than a vaccine in the trash can.
SHAPIRO: Do you think this is a reflection of too much emphasis being placed on prioritization and not enough on just getting the jabs into people's arms?
ADALJA: I do think that's the case. And the priority groups were a good thing, but we don't want those to be an obstacle to getting vaccine into people's arms. And if people are dogmatically sticking to these priority groups because they would rather stick to those groups then put something in an arm of a Phase 1B or, God forbid, a Phase 1C person, I think that's the wrong approach. So I do think the flexibility of now saying if you're above 65 years of age, you can get vaccinated - I think that's good. It allows vaccinators that flexibility, and it avoids kind of governors coming up with really Draconian, backwards types of rules that are causing people to be worried about their license if they deviate from a priority group.
SHAPIRO: There's a problem related to vaccine wastage, which is that nearly half the doses distributed are still sitting in cold storage, waiting to be shot into arms. That's 20 million doses or so. What is the reason for that?
ADALJA: There's not really one good reason. I think there's multiple reasons, and some of it may be that there is just not good communication between the federal government and the state government. So, for example, in Florida, you're hearing the Florida governor say, we're going to keep those doses on our shelves because we're not confident that we'll get our second doses in time from the federal government. In other places, they just don't have enough vaccinators to do this. They don't have people to actually put the vaccine into people's arms. It's something that was predictable. It was something we knew was going to happen when this was left to states that were under-resourced. And I think it needs to be cleaned up pretty quickly. And we can't have the state and federal governments kind of bickering over this, and that's what's happening now, even in the Biden administration.
SHAPIRO: That's Dr. Amesh Adalja, an infectious disease doctor at Johns Hopkins University.
Thank you so much.
ADALJA: Thanks for having me.
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