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As the rate of COVID vaccinations increases, so do the reports of doses that will be lost. And that’s more than a handful at the end of the day due to several cancellations of appointments. Healthcare professionals are trying to address the problems that lead to waste, but without delaying the introduction of life-saving vaccinations.
The incidents included 335 discarded doses in Lee County, North Carolina that were damaged in shipping, and recent problems in Tennessee, where nearly 5,000 doses went to waste in February, prompting additional federal oversight.
“I’ve definitely lost some sleep from this, for sure,” said Beth Ann Wilmore, director of nursing at Mercy Community Healthcare in Franklin, Tennessee. She manages the inventory of COVID vaccines at the non-profit clinic, which began receiving shipments a month ago.
Clinics like Mercy are used to handling vaccines, but none so valuable as to have such special cooling needs.
“I was definitely waking up in the middle of the night wondering how the temperatures were going, and I thought, ‘Okay, I hope it’s good and it doesn’t give me a flag or anything. “
Many public health centers receive Moderna vials, which are easier to use than Pfizer but still difficult. Moderna vials last up to 30 days after removal from deep freezing, unlike five days for Pfizer. But once the seal on the vial breaks, there are only six hours to use the photos.
So far, there has been no waste at Mercy. But Wilmore has heard horror stories from elsewhere in the state.
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In neighboring Murfreesboro, Tennessee, the local school district received thousands of doses to vaccinate teachers on the last weekend in February. But they were placed in an unapproved freezer. The shipment temperature sensor flashes with an error code. As a precaution, they were advised to discard them all.
“My heart hurts,” said Dr. Lisa Pierce, a health commissioner in Tennessee who uncovered one of the country’s biggest leaps in corruption.
She says the losses are painful because the shots are “priceless” in the midst of this deadly pandemic. But this is one of the risks of having so many vaccine sites.
As a way to increase access and equity, Tennessee now has more than 700 vaccination sites in the state, and is more likely to open as shipments increase in the coming weeks.
“It definitely raises the level of concern when you have more partners – especially partners who are not under your direct control,” she says.
Even the major city health services in Tennessee – which operate independently of the state health department – face problems.
Thousands of doses were dumped in Knoxville, apparently confused by a bound shipment of dry ice. In Memphis, the district health director resigned after slowly revealing that batches of nearly 2,500 doses had been allowed to expire several times. Some leaks were related to winter weather, but poor management at the county pharmacy was also a factor.
The state has called on staff from the Federal Centers for Disease Control and Prevention to help monitor the spread of vaccines in Memphis and has stepped up audits of all local health departments in the state.
There are so many ways to break down the doses. In West Palm Beach, Florida, the power of a mobile refrigerator was turned off. In Connecticut, the refrigerator door did not close properly, although the doses were saved in time after consultation with Moderna.
Health officials have worked hard not to lose doses, such as a makeshift mass vaccination at a homeless shelter in Nashville after winter storms canceled hundreds of meetings.
Dr Kelly Moore, deputy director of the Immunization Coalition, says some deterioration is expected. It is still well below 1% of doses, even in countries like Tennessee and Florida, which have revealed large losses.
“I’d be more worried if I saw reports of zero doses wasted,” Moore said, because then her concern would be transparency.
“You want to see a little bit of waste because it means that people are paying attention and that there are accidents in the real world and that they are responding properly,” she said. You just don’t want to see negligence.
It is hoped that abuse will be easier to avoid with the newly approved Johnson & Johnson vaccine. In addition to being a single dose, it remains effective even after storage in a normal refrigerator for months.
This story was created as part of NPR’s partnership with Kaiser Health News and Public Radio in Nashville.