Coronavirus

Why Don't We Know How Many Vaccine Doses Are Being Thrown Away?

At a time when supply is constrained and time is of the essence, medical providers in many states are throwing precious doses away.

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With health care providers running out of doses in droves and hustling to cancel thousands of appointments, many face an additional problem: Hobbled by strict guidelines for who can and cannot receive vaccines right now, and fines for flouting the rules, perfectly good doses are being thrown in the garbage. "I have personally heard stories like this from dozens of physician friends in a variety of different states. Hundreds, if not thousands, of doses are getting tossed across the country every day," Ashish Jha, dean of the Brown University School of Public Health, told NBC News.

It's an entirely predictable outcome. When vials of doses are thawed to prepare them for use, they cannot be refrozen. Vials that have been punctured must be used within just a few hours. Combine those factors with tight state-imposed parameters for which people can currently receive the vaccine and waste is practically unavoidable—when people cancel appointments with little notice, it can be hard for health care workers to find new recipients off the street who qualify under the state's current phase. They're left either breaking the law or throwing doses in the garbage.

To make matters worse, state departments of health are struggling to tell how often it's happening or how many precious doses have been squandered. Although many states mandate reporting of vaccine waste, providers have little incentive to comply: If New York's system is any indication, they might end up fined or under investigation.

In the Empire State, mass vaccination sites at Yankee Stadium and Citi Field have put operations on hold until the city can receive 200,000 shots per week—double what's currently expected. But just a few weeks ago, providers were throwing out doses. As I wrote then:

"On December 28, [Gov. Andrew Cuomo] signed an executive order rolling out strict penalties—up to $1 million in fines, plus loss of medical license—for medical providers who allow people to skip the state-issued vaccination line, even when those doses are about to expire….Predictably, The New York Times reported today that some clinics throughout New York City, like the Family Health Center of Harlem, are throwing out doses that are about to expire."

Meanwhile, a hospital in New Rochelle, New York, came under investigation for potentially allowing people to skip the vaccine line. All their doses were seized and reallocated elsewhere.

Medical providers are engaging in indefensible but perfectly rational behavior when they throw out doses; it's reasonable to be afraid of fines, and they have no incentive to report vaccine waste to the Centers for Disease Control and Prevention (CDC), despite being asked to do so. As the nonprofit investigative outlet ProPublica reports:

"In Washington, a health facility allegedly threw out some COVID-19 vaccine doses at the end of workers' shifts because staff believed state guidelines blocked them from giving unused shots to people below the top priority tier. In Maryland, workers appear to have tossed thawed doses when they ran out of time to administer them safely. How many doses, exactly, have been wasted in those states is unknown because neither state is tracking unused or wasted vaccines."

ProPublica found that some amount of vaccine waste is also occurring in Indiana, Michigan, and New Jersey; it's totally unclear whether these are isolated incidences or not. In Pueblo, Colorado, 300 doses had to be thrown out after a refrigeration malfunction. And NBC News reports that this is happening in Oregon, Ohio, and Massachusetts as well. Providers and state officials in North Carolina and Virginia allege they're doing a bit better,

This latest government failure to track the number of doses going to waste is awfully reminiscent of the failure to track school reopening data—something you'd think would be absolutely essential to determining whether school districts can return to in-person instruction. Once those data were collected, experts like Brown University economist Emily Oster were able to make the cautious case for school reopenings, being able to be more confidently assert that schools were not a significant vector for COVID-19 transmission. It's equally crucial in this situation that states have accurate data as to how many doses are being thrown out and why.

"Vaccines are worth more than gold and we don't have enough. We can't afford to waste a ml.," George Mason University economics professor Alex Tabarrok tells Reason. "Indeed, until production is much higher we need to consider every possible method of 'stretching' our doses such as using low dead-volume syringes, half-dosing, and moving to First Doses First."

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  2. At a time With health care providers running out of doses in droves and hustling to cancel thousands of appointments, many face an additional problem: Hobbled by strict guidelines for who can and cannot receive vaccines right now, and fines for flouting the rules, perfectly good doses are being thrown in the garbage…….MORE DETAIL.

    1. Unfortunately we’re in for more government management getting in the way. Biden promised to “manage the hell” out of the vaccination process.
      Instead what is needed is for government to sweep away burdens.

      The number of health care providers is crazy burdensome in the vaccine administration process. In one clinic that I volunteered to work a day shift, 8 health care providers (one MD, 5 nurses, 2 non-nurse assistants), were able to give only 140 shots in 8 hours.

      Keep guidelines as guidelines, not strict rules. Once a rule is in place, and penalties are attached (Cuomo and his million dollar fine for each vaccination of an ‘ineligible’ person) suddenly throwing out thousands of doses to prevent one fine looks like a fiscally sensible action.
      Second, streamline the consent process. There is no other drug that I have prescribed or administered in 25 years that has a pages long written consent document. Yet vaccines have this burden. Information is easily available now. Consent is implied when one rolls up their sleeve. Done.

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      1. Yet, in boot camp, they manage to vaccinate a whole company of 200 in about ten minutes.

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  4. While the CDC stated yesterday that 25 million Americans have tested positive for covid so far, studies have found 3 – 10 times more Americans were infected with covid than have tested positive. With increased testing, that ratio now appears 3 – 7 times (depending upon location), indicating that 100 – 150 million Americans have already been infected with covid.

    Herd immunity occurs after two thirds of people (in families, workplaces, communities, counties and/or states) have been infected or vaccinated, and the risk of infection declines by half when/after half of people have been infected or vaccinated.

    Despite NO news stories, the herd immunity process has been occurring in thousands of communities, hundreds of counties, and more than a dozen states, led by the Dakotas. By the time 10% of Americans receive covid vaccines, herd immunity will have already protected most Americans from covid.

    But Big Pharma, Democrats and lamestream media propagandists continue to deceive Americans to believe that herd immunity can/will only be attained via mass vaccinations. Recent news stories indicate that Big Pharma (and likely Biden’s CDC and FDA) plans to make/sell enough vaccines for all Americans (including everyone who is already immune due to a past infection).

    107 US counties have surpassed a 13% covid rate (i.e. positive tests), and are very close to achieving herd immunity (data as of 1/22/2021).

    Crowley, CO – 29.8%
    Dewey, SD – 23.2%
    Lincoln, AR – 22.2%
    Chattahoochee, GA – 21.8%
    Norton, KS – 21.8%
    Bent, CO – 21.6%
    Bon Homme, SD – 21.5%
    Lake, TN – 21.1%
    Trousdale, TN – 20.8%
    Buffalo, SD – 20.4%
    Buena Vista, IA – 19.8%
    Ellsworth, KS – 18.5%
    Alfalfa, OK – 18.2%
    Eddy, ND – 18.2%
    Dakota, NE – 18.0%
    Jackson, AR – 18.0%
    Childress, TX – 17.8%
    Lee, AR – 17.4%
    Lafayette, FL – 17.2%
    Nobles, MN – 17.0%
    Lassen, CA – 16.9%
    Hale, TX – 16.9%
    Foster, ND – 16.9%
    Big Horn, MT – 16.8%
    Seward, KS – 16.8%
    Menominee, WI – 16.7%
    Pawnee, KS – 16.5%
    Sheridan, KS – 16.4%
    Logan, CO – 16.3%
    Walsh, ND – 16.1%
    Ford, KS – 16.0%
    Wayne, TN – 16.0%
    Texas, OK – 15.9%
    Finney, KS – 15.9%
    Yuma, AZ – 15.8%
    Lee, KY – 15.8%
    Aurora, SD – 15.7%
    Morton, ND – 15.4%
    Stutsman, ND – 15.4%
    Potter, SD – 15.4%
    Santa Cruz, AZ – 15.3%
    Nelson, ND – 15.2%
    McKinley, NM – 15.2%
    Lyman, SD – 15.0%
    Lincoln, CO – 14.9%
    East Carroll, LA – 14.9%
    Lubbock, TX – 14.9%
    Burleigh, ND – 14.8%
    Benson, ND – 14.6%
    Dickey, ND – 14.6%
    Sioux, ND – 14.6%
    Chicot, AR – 14.5%
    Madison, ID – 14.5%
    Maverick, TX – 14.4%
    Cass, IL – 14.4%
    Davison, SD – 14.4%
    Rolette, ND – 14.2%
    Toole, MT – 14.1%
    East Feliciana, LA – 14.1%
    Woodward, OK – 14.1%
    Faulk, SD – 14.0%
    Oglala Lakota, SD – 14.0%
    Plymouth, IA – 14.0%
    Lawrence, IL – 13.9%
    Douglas, SD – 13.9%
    Haywood, TN – 13.9%
    Nemaha, KS – 13.9%
    Griggs, ND – 13.8%
    Colfax, NE – 13.8%
    Beadle, SD – 13.7%
    Minnehaha, SD – 13.7%
    Lamb, TX – 13.7%
    Gove, KS – 13.7%
    Scurry, TX – 13.7%
    Crocket, TX – 13.6%
    Stark, ND – 13.6%
    Fayette, IL – 13.6%
    Kearny, KS – 13.6%
    Golden Valley, ND – 13.6%
    Whitfield, GA – 13.6%
    Wilbarger, TX – 13.5%
    Grand Forks, ND – 13.5%
    Crawford, IA – 13.5%
    Clinton, IL – 13.5%
    Pickett, TN – 13.5%
    Republic, KS – 13.5%
    Ramsey, ND – 13.4%
    Potter, TX – 13.4%
    Culberson, TX – 13.4%
    Towner, ND – 13.3%
    Sanborn, SD – 13.3%
    Madison, LA – 13.3%
    Sevier, AR – 13.3%
    Obion, TN – 13.3%
    Henry, IA – 13.2%
    Dodge, WI – 13.2%
    Coddington, SD – 13.2%
    Jones, TX – 13.2%
    Okfuskee, OK – 13.2%
    Sioux, IA – 13.1%
    Jones, IA – 13.1%
    Ward, ND – 13.0%
    Jerauld, SD – 13.0%
    Rush, KS – 13.0%
    Webster, IA – 13.0%
    Wright, IA – 13.0%

    1. 20 states with the highest covid case rate (i.e. positive tests) are
      https://www.npr.org/sections/health-shots/2020/09/01/816707182/map-tracking-the-spread-of-the-coronavirus-in-the-u-s#curves

      ND – 12.7%
      SD – 12.1%
      UT – 10.4%
      RI – 10.4%
      TN – 10.3%
      WI – 10.0%
      IA – 9.9%
      AZ – 9.8%
      NE – 9.7%
      AR – 9.4%
      OK – 9.4%
      KS – 9.2%
      IN – 9.0%
      AL – 9.0%
      ID – 8.9%
      MS – 8.8%
      NV – 8.8%
      WY – 8.7%
      IL – 8.7%
      MT – 8.6%

      So far, 7.78% of Americans have tested positive for covid.

      1. The graphs showing new covid cases in each state at
        https://coronavirus.jhu.edu/data/new-cases-50-states
        clearly document that herd immunity appears to be occurring in many northern Midwest and Plains states, led by North Dakota, South Dakota, where the number/rate of new covid cases has plummeted during the past ten weeks.

        So why the news media blackout about natural herd immunity?

        The correct answer is that any truthful acknowledgement of “natural herd immunity” is not permitted by the left wing lockdown and mask mandate control freaks at CDC, NIH, FDA, US SG, virtually all Democrats (including Biden, Pelosi, Schumer) and their left wing media propagandists (apparently including Reason).

        1. They changed the fucking definition of herd immunity.
          They’re transparent to all but the wilfully blind

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          3. You can’t change the definition of a biological theory. Biology determines the outcome. The theory derives from veterinary medicine. Biology is observational. It is not like engineering an aircraft. There is no set definition since every disease is different, immune response is complex and the pathogen changes as the current virus is doing.

            You as an individual either have effective immunity or you do not. There is really no such third entity as herd immunity. The pathogen can be effectively eradicated in nature as in smallpox, controlled as in measles, go away on its own as in the original SARS for reasons still not understood, or continue as in influenza with limited management from year to year.

            I think what the term has come to mean in common usage, a mutation in language, is when can we go to life without all of these masks, distancing and everything we are sick and tired of. That is not what it means in biological terms.

            Given the ability of this virus to mutate and our limited ability to fight it. Given how it has become a political issue and the amount of disinformation out there it is very hard to say how this will impact our daily lives six months or two years from now.

            1. You can change whatever the fuck you want … if you are a Prog Democrat.

              See: Gender.

      2. “led by the Dakotas” That makes two things they lead in. Covid herd immunity and the “Who gives a crap about those states” list.

    2. (Data as of 1/28/2021)
      Crowley, CO – 30.1%
      Chattahoochee, GA – 23.9%
      Dewey, SD – 23.4%
      Lincoln, AR – 22.6%
      Norton, KS – 21.8%
      Bent, CO – 21.8%
      Lake, TN – 21.4%
      Bon Homme, SD – 21.2%
      Trousdale, TN – 21.0%
      Buffalo, SD – 20.4%
      Buena Vista, IA – 20.0%
      Ellsworth, KS – 18.6%
      Alfalfa, OK – 18.6%
      Eddy, ND – 18.6%
      Jackson, AR – 18.1%
      Dakota, NE – 18.1%
      Childress, TX – 17.8%
      Lee, AR – 17.7%
      Bethel, AK – 17.6%
      Lafayette, FL – 17.4%
      Lassen, CA – 17.2%
      Hale, TX – 17.1%
      Nobles, MN – 17.1%
      Forest, PA – 17.1%
      Foster, ND – 16.9%
      Seward, KS – 16.9%
      Big Horn, MT – 16.9%
      Menominee, WI – 16.9%
      Pawnee, KS – 16.7%
      Logan, CO – 16.6%
      Sheridan, KS – 16.5%
      Wayne, TN – 16.3%
      Yuma, AZ – 16.3%
      Walsh, ND – 16.2%
      Ford, KS – 16.0%
      Finney, KS – 16.0%
      Texas, OK – 16.0%
      Lee, KY – 16.0%
      Aurora, SD – 15.9%
      Lincoln, CO – 15.8%
      Santa Cruz, AZ – 15.8%
      McKinley, NM – 15.7%
      Potter, SD – 15.5%
      Morton, ND – 15.5%
      Stutsman, ND – 15.4%
      Lyman, SD – 15.4%
      Nelson, ND – 15.2%
      East Carroll, LA – 15.2%
      Lubbock, TX – 15.1%
      Maverick, TX – 15.0%
      Burleigh, ND – 14.9%
      Chicot, AR – 14.8%
      Benson, ND – 14.7%
      Dickey, ND – 14.7%
      Sioux, ND – 14.7%
      Madison, ID – 14.7%
      Cass, IL – 14.7%
      Davison, SD – 14.6%
      Culberson, TX – 14.5%
      Woodward, OK – 14.4%
      Rolette, ND – 14.4%
      Faulk, SD – 14.2%
      Oglala Lakota, SD – 14.2%
      Imperial, CA – 14.2%
      Haywood, TN – 14.2%
      Toole, MT – 14.2%
      East Feliciana, LA – 14.2%
      Whitfield, GA – 14.1%
      Plymouth, IA – 14.1%
      Crocket, TX – 14.1%
      Douglas, SD – 14.0%
      Colfax, NE – 14.0%
      Lawrence, IL – 14.0%
      Nemaha, KS – 13.9%
      Minnehaha, SD – 13.9%
      Yell, AR – 13.9%
      Lamb, TX – 13.9%
      Scurry, TX – 13.9%
      Webb, TX – 13.9%
      Val Verde, TX – 13.8%
      Griggs, ND – 13.8%
      Beadle, SD – 13.8%
      Gove, KS – 13.8%
      Kearny, KS – 13.8%
      Wilbarger, TX – 13.8%
      Clinton, IL – 13.8%
      Republic, KS – 13.7%
      Crawford, IA – 13.7%
      Stark, ND – 13.6%
      Fayette, IL – 13.6%
      Golden Valley, ND – 13.6%
      Sevier, AR – 13.6%
      Pickett, TN – 13.6%
      Okfuskee, OK – 13.6%
      Grand Forks, ND – 13.6%
      Ramsey, ND – 13.6%
      Potter, TX – 13.6%
      Towner, ND – 13.5%
      Obion, TN – 13.5%
      Richmond, VA – 13.5%
      Henry, IA – 13.5%
      Madison, LA – 13.5%
      Rush, KS – 13.4%
      Jones, TX – 13.4%
      Kings, CA – 13.4%
      Dodge, WI – 13.4%
      Morgan, KY – 13.3%
      Sanborn, SD – 13.3%
      Utah, UT – 13.3%
      Coddington, SD – 13.3%
      Jones, IA – 13.3%
      Sioux, IA – 13.2%
      Wright, IA – 13.2%
      Hemphill, TX – 13.2%
      El Paso, TX – 13.2%
      Roosevelt, MT – 13.2%
      Perry, IL – 13.2%
      Deaf Smith, TX – 13.1%
      Tom Green, TX – 13.1%
      Dyer, TN – 13.1%
      Miami Dade, FL – 13.1%
      Webster, IA – 13.1%
      Dubois, IN – 13.1%
      Ward, ND – 13.1%
      Kusilvak, AK – 13.1%
      Jerauld, SD – 13.0%
      Pershing, NV – 13.0%
      Teton, WY – 13.0%
      Charles Mix, SD – 13.0%
      Brule, SD – 13.0%
      Thomas, KS – 13.0%
      Putnam, TN – 13.0%
      Moore, TN – 13.0%
      Saline, NE – 13.0%
      Dawson, TX – 13.0%
      Kandiyohi, MN – 13.0%

      1. 138 counties have surpassed a 13% covid rate (i.e. percent of population who tested positive)

  5. ” . . . Medical providers are engaging in indefensible but perfectly rational behavior when they throw out doses . . . ”

    Thank God I was educated so long ago that English had rules.
    Come on, man!
    Is it rational, or indefensible? It cannot be both.

    Hint: The act of throwing out doses to avoid breaking laws or regulations, or even a politician’s whim (given that the politician can cut off your livelihood) is rational.
    The laws, regulations, and vague mumblings of politicians regarding the vaccines is indefensible.

    1. Sure it can. Just because something is rational doesn’t make it moral.

      1. Anything rational is to some extent defensible on that basis.

        1. Yes. Given the circumstances it is perfectly defensible.

      2. That’s an entirely different question.

    2. It’s indefensible to throw doses away, but it’s rational to avoid a million dollar fine and loss of license by following the government’s indefensible rules.

    3. Dude, have you not heard of poetic license? The deliberate use of mutually exclusive adjectives is there for emphasis.

      It’s indefensible because they are wasting such a scarce resource.
      However, it’s rational because they face absurd fines and punishments if they don’t. Only an imbecile would not throw out medicine in this situation.

      1. Stupid but normal.

    4. They can defend their actions as rational. But it would also be rational to take the risk of a fine and give out all the vaccine anyway.

  6. “Why Don’t We Know How Many Vaccine Doses Are Being Thrown Away?”

    Because there is a slight possibility that it might cause harm to the democrat’s takeover of the federal government.
    Next question?

  7. “At a time when supply is constrained and time is of the essence, medical providers in many states are throwing precious doses away.”

    Eh, whatever. President Biden vowed to shut down the virus and he’s already well on his way to accomplishing exactly that. No sense nitpicking occasional questionable behavior at the state or local level.

  8. Who cares?

    Per Biden, there is nothing we can do anymore to stem the tide of the pandemic.

    1. That was a deceptively edited, out-of-context quote. In fact, Biden is literally shutting down the virus right now.

      1. All of the left wing covid viruses on federal property have been wearing masks, social distancing and washing their hands, as per the Executive Order from the Big Guy.

        But the Republican and libertarian covid viruses aren’t complying with the Executive Order.

      2. Much like how the Obama policy successes were Bush policies, Biden’s successes will be Trump policies.

      3. By “literal” he means “not at all”. What an idiot.

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  9. I read about the fastidious nature of the vaccine the other day and thought that there has to be a plan to use vaccine about to expire. Any group vaccinating should have a back up list of people that can come in on short notice to use extra doses. That backup list should be open to basically anyone who can get to the center in time.

    This of course opens the door to line cutter, but that should be treated separately. Address this yes, but not at the expense of wasting vaccine.

    1. Or, we could make it less complicated.

  10. Nice sign. Looks like something straight out of the Soviet Union.

    1. Funny. Most vaccines and other shots I’ve gotten have been on the outside of the left arm/shoulder. Is NY doing it wrong?

    2. It is what you advocated for. Government decisions on who gets to stand there. Own it.

  11. Because it would embarass the Party of Science!

  12. I don’t know if I’m guessing correctly, but my one guess is that the vaccines come in multi-dose vials. Open a vial of X doses, and if you don’t use X doses by Y time, Z doses go in the trash.

    I DO know this to be the case with an as-yet-unapproved vaccine. I’m a Phase 3 trial volunteer for Novavax’s product. The day I came in to get my shot, I got a bad new / good news story.

    Bad news: You’re our last schedule volunteer for the day, and we just used the last dose from a 10-dose vial. If we open a new vial, we’ll have to throw 9 doses away

    Good news: If you’re willing to re-schedule, you get paid for two trial visits instead of one.

    I didn’t really sign up for the money (I participate in research studies whenever I get the opportunity because I think it’s cool to “help advance science” when I can), but I also don’t turn it down.

    1. Ten dose vials.

    2. Yes, this is true for both approved vaccines, each vial is multiple doses.

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  14. Other than that, though, socialized medicine really is the most efficient.

    1. I prefer effective to ‘efficient’.

      1. Sadly, they go together .

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  16. What would be wrong with a stand-by list or line?

    This does not seem like rocket science…

    1. It doesn’t put Stunning and Brave Persons of Color at the front of the line, even though they’re already skeptical of a rushed vaccine because of the Tuskegee experiments, and that’s all right too, because until they get vaccinated, no one can get vaccinated.

      1. Incidentally, this is why the hillbillies in rural red states are far more successful at getting people vaccinated right now than the Big Brains in WeFuckingLoveScience! Land.

    2. Why is there a specialized line in the first place that doesn’t consist solely of the most vulnerable?

  17. It’s not just people who wouldn’t qualify who would benefit – people who are in the current category to receive the vaccine but who are unable to find an open appointment would appreciate the opportunity.

    1. The only criteria for getting these shots should be, “We have X number of vaccine shots available at these locations through X date. If you want one, call us for an appointment and we’ll stick you at the designated time. Don’t be late.”

  18. We are talking about an organization – FEDGOV – that says it is too expensive to try to limit waste, fraud and abuse of its systems to less than 10% of spending.

  19. Suddenly everybody’s a fucking logistics expert.

    1. You don’t have to be a logistics expert to know that those in charge of the logistics of vaccine distribution aren’t.

  20. My mother is in her 80s. She got one of those lucky doses. A nursing home had extras which we learned about through family. They drove right up. She is scheduled for her booster in about a week.

    There is no reason to throw away doses.

  21. Look, it’s either indefensible or it’s reasonable. It can’t be both.

    1. It says indefensible but RATIONAL behavior. Reasonable is used to describe the desire to avoid fines. And things absolutely can be indefensible and rational, see China and the rule that makes you pay for the medical care of someone you seriously injure with your car, for life. The indefensible, but rational, behavior of some drivers in China is then to make sure they kill the person they hit, because it will cost them less in the end, if they don’t get caught for murder (or bribe the cops to look the other way).

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