Here's how more than 18,000 doses of the COVID vaccine went to waste in Pennsylvania

More than 700 COVID-19 vaccine doses were wasted in Pennsylvania over the past two weeks as demand for the vaccine continues to drop, according to state health data.

Providers reported 18,644 spoiled doses since December, when the state began receiving the Pfizer vaccine, the first of three vaccines to receive emergency use authorization from the U.S. Food and Drug Administration. 

The wasted doses represent a small fraction, 0.18%, of the more than 10 million doses that have been shipped to the state and given to hospitals, pharmacies, and other providers, according to the Pennsylvania Department of Health. 

Spoilage caused more than 37% of cases — for a total of 6,949 wasted vaccines — meaning doses either expired or were not stored at the correct temperature, often due to equipment failure, state health officials said. 

Another 6,731 doses were wasted for reasons listed as "other," and 4,002 doses were wasted because a vial was opened but not administered.

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A broken vial or syringe accounted for 686 wasted doses, a vaccine being drawn but not administered led to 263, and 13 doses were simply lost or unaccounted for.

In recent months, state health officials have urged health care providers to vaccinate as many people as possible, allowing health care facilities, clinics and other smaller vaccine providers to open a vial to vaccinate just one person.

Still, supply has grown so much greater in demand that in some instances vaccination sites may let shots go to waste rather than turn away someone who has come to be vaccinated. 

The vaccine is stored in vials with multiple doses and once a vial is open all the vaccine must be used within a limited time or discarded.

Most of the recent wasted doses can be attributed to the new guidance for vaccine providers, although doses also can be lost through incorrect storage, power outages, mechanical failures and more. 

Data being kept a secret

Previously, the Wolf administration had refused to release details about wasted coronavirus vaccines, citing a disease prevention law, but in recent weeks has added it to the list of data tables available on the department of health website.

The CDC does not publicly report state-level data for wasted doses, but, agency spokeswoman Kate Grusich said the amount of spoiled vaccine remains extremely low compared to the total number shipped and administered. The CDC has anticipated an increase in wasted doses as supply expands and opportunities to receive the vaccine increase across the country, Grusich added.

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"A growing number of providers – including smaller provider sites – are now receiving vaccine; vial sizes for some COVID-19 vaccines have increased; and vaccine vials may be opened, even without the guarantee that every dose will be used, to ensure providers don’t miss an opportunity to vaccinate every eligible person who wants to be vaccinated," Grusich said. 

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Handling the prospect of potential leftovers

Hospitals and county health departments offering the vaccine take a patchwork approach to deciding how to handle the prospect of potential leftovers, which in large part deserves credit for the low number of discarded doses. 

Since the health system started vaccinating people in December, its vaccine sites have amended how workers prepare the doses to decrease the chance of having leftovers. Initially the sites would prepare doses every four hours, knowing that the vaccine must be used within six hours, said Mark Goedecker, vice president and regional medical director at WellSpan Health.

After having some no-show appointments, Goedecker said, workers began decreasing the window further. 

"We really have that down to an art where there are no extra doses," he said.

Using this technique, the only way an extra dose would arise would be if a person with an appointment fails to show in the last hour of the clinic.

When there are extra doses, the vaccine site staff works to find someone in the hospital to give the dose too.

Vaccination pace slowing

Vaccine administration in Pennsylvania has significantly slowed in recent weeks though.

State health data show a steady decline in new vaccinations each week since April 5, when the state reported a high of 1.8 million doses given. More than 778,000 doses were administered May 10-16. That number includes first and second doses. 

A few months ago when demand far outstripped supply, conversation swirled around when in the calendar year Pennsylvania might reach the Holy Grail of herd immunity.

Health officials talked about 70% percent being the goal. Dr. Anthony Fauci, the nation’s top infectious disease expert, has said the nation must achieve a vaccination rate of about 80% to reach herd immunity. Other health experts have said herd immunity won’t be reached until 90% of the population is vaccinated.

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Now, nearly 60% of all Pennsylvanians have been vaccinated with at least one dose of the COVID-19 vaccine, and state officials have said there would be enough vaccine to immunize 80% of everyone 16 and over by the end of June.

That would mean Pennsylvania could hit a key target to achieve herd immunity before the 4th of July.

"Wouldn’t that be a wonderful 4th of July celebration, to hit 80% community immunity in the state of Pennsylvania?" said Acting Physician General Denise Johnson. "I mean we can't really put a timeline on it, but it's nice to think about."

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