How Many Vaccine Shots Go to Waste? Several States Aren’t Counting. | Talking Points Memo

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This is a companion discussion topic for the original entry at https://talkingpointsmemo.com/?p=1355877

I was talking to my dentist the other day. His wife is a nurse. Recently when it was close to the end of the day he received a call from his wife to come to the hospital for his first dose. He took her up on the offer immediately. That was how her hospital was handling extra doses rather than letting them go to waste.

It seems the providers around here are doing their best they to not waste vaccine, but your mileage may vary.

My daughter in law is a school teacher. I am really happy about making vaccine available to teachers and other essential workers as soon as possible.

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This is all a function of the lack of planning once the Feds shipped the product. No infrastructure or funding at the State level to make sure this got to the final destination. This was always the end-game for the previous administration. It was soundly demonstrated when it was announced the administration had not ordered additional product after the initial shipment.

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If you’ve ever worked around medical functionaries you’ll know how terrifying their " I’m perfect " bullshit is. I can easily see some fat ass in scrubs dumping valuable vaccine because of some petty this or that and thinking they really did a good thing. The rule must be: absolutely no avoidable waste and that applies to lard asses in white coats too.

Think of how rule bent you’d have to be to think it a good thing to trash life saving vaccinations because you thought the right people to be vaccinated were not in your chair? That is medical minion thinking in a nut shell. I see it everyday.

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The biggest problem they probably faced was the temperature requirement of -90. Once the vial is opened/removed, the clock starts ticking.

We need more of the vaccines that don’t have that requirement and, let’s face it, the -90 was probably the dominant vaccine made available in the US. I can’t fault ALL of the healthcare workers. There are limits that must be strictly adhered to. That limit of -90 degrees was ridiculous, but it’s what we have.

And then, of course, there was the idiot in Wisconsin. Not denying there isn’t a problem.

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It seems that here in Delaware, the governor is aware. Already calling unexpected vaccination setups at DMV open to those who would be next in the priority channel. Maybe it’s just harder in a bigger state.

That would be Pfizer’s. The Moderna model uses ordinary freezers and refrigerators

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the temp thing is not an issue if you use the vaxs as their manufacture instructs. There’s no reason to pull more vax than you need from the freezer. No matter what “good idea” there is for doing so. The newer Moderna vax only needs -20 so that will ease up the equipment needs but -90 is easy to obtain. This can be done and done well as long as you rein in the “I’m perfect” assholes and use common sense ( which is scarce in the medical biz )

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As we continue to try and push inoculation of the vaccine into patients down to more and more sites, don’t we risk that those bottom deliverers are less able to efficiently use the vaccine without waste? Also, I’m nervous about getting my shot at a non medical facility. I like the Drs and nurses at my primary care facility, a hospital run practice but I have much less confidence in the local CVS.

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And how much training was actually given to these folks? That’s another issue I can’t answer. What do they know and what was left out of the discussion?

I know there have been stories of a vial being pulled, vaccinations given and product leftover. If the vial had five doses and only three were administered, what to do with the rest? In some cases, folks were pulled in almost off the street so the vial could be entirely consumed. And then there’s the overfills. There were all sorts of issues here, some of which can be blamed on the health care workers, but there is a whole lot more going on that we don’t know about. I’m not entirely comfortable blaming the whole mess on health care workers.

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Except that it’s a bit more complicated than just pulling one vial. The whole package has the temperature requirements, and once you break open the box, the clock is ticking not just on one vial but all of them.

If J&J’s “regular” vaccine, with the same requirements as a normal flu vaccination (basic refrigeration and a single dose) gets approved, that’ll be a major game-changer. Until then, there’s a really complex process beyond just getting the boxes to the right place.

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Again…most problems are foreseeable…so foresee. Don’t pull that vial until you have sufficient patients ready. It can be done. An ex-employee of mine that now administers COVID vax protocols for the U of F system in Jacksonville does just that. They are vaccinating 65 plus, medical workers, grocery store workers and those at high risk. BUT…if they run out of qualified patients they dump the vax they have on others. No waste. It can be done.

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I’m having difficulty understanding why knowns are a problem. The vials that Pfizer puts out ( the one I got ) are multi dose and come in multi pac ( I did not count them ). You can pull one vial and return the pack to the cold store. But you do know how many units you have and the risks. So fucking fix that. Look at that line outside. See 50 folks? then move. TB syringes in peel packs, isoprop wipes, red waste box and go for it. Vaccinate and put in the waiting area for 20 min. Nest. See 10? wait. You don’t have a sufficient patient load to expose vax. It’s just not that hard unless you have folks with their heads greased in ego and up their asses running the show. ( common ) . If you have that…get rid of those assholes and get this very easy thing done.

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Works for a one-dose, much more complex for a two-dose.

You can’t just shoot the arms of every passerby without a plan to deliver the second dose from the same manufacturer to the same individual three or four (depending on the vaccine) weeks down the road.

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It sounds as if a lot of states have taken the former administration’s complete lack of planning as a model for how they should conduct their operations.

Of course, the complete lack of federal funding for doing anything properly doesn’t help. People who are already stretched to breaking have to come up with high-quality plans and implement them in their spare time.

Castor…you’re better than that. No one suggested anything like what you say. I know it can be done without waste and efficiently because I just yesterday spoke with a personal friend that does just that. She puts together a huge vaccination program in Florida of all places and gets it done. It’s no different than any other large scale operation. Identify your needs, your possible problems and tailor to meet that. If vaccination is being wasted that is an avoidable sin and should not be passed off as inevitable. I’d shitcan the entire crew that wasted a flat of CoVax and everyone should do that.

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They just had to throw out 12,000 doses of Moderna’s vaccine in Maine because it had been transported at twenty below. Google it. Moderna only needs -4 below zero.

Moderna, Inc. (Nasdaq: MRNA), a biotechnology company pioneering messenger RNA (mRNA) therapeutics and vaccines to create a new generation of transformative medicines for patients, today announced new data showing that mRNA-1273, its COVID-19 vaccine candidate, remains stable at 2° to 8°C (36° to 46°F), the temperature of a standard home or medical refrigerator, for 30 days. Stability testing supports this extension from an earlier estimate of 7 days. mRNA-1273 remains stable at -20° C (-4°F) for up to six months, at refrigerated conditions for up to 30 days and at room temperature for up to 12 hours

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Reason number 4 billion, three hundred forty-eight million, six thousand six why we needed a national plan to begin with.

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U-M certainly has it together now. There were about 10 stations set up. Walk in, go up to the floor where they’re given, get checked in, and wait in line to be called. Get the shot and the written card, which is brought back when you get the second dose. Then sit in chairs provided for 15 minutes to make sure you feel okay, make the second appointment and leave. It was a constant stream of people going in and coming out at the club at Michigan Stadium.

Painless and quick.

ETA U-M had vaccinated 30,000 people as of yesterday. I’m one!! Other hospital systems are also doing it and county health departments.

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Bureaucratic screw-ups get so contaminated (excuse the pun) with gossip, exaggeration, blame-placing, embellishment and censorship that it’s impossible to know WTF happened. Sometimes a blue ribbon investigation can figure it out, but in the meantime people need their vaccines.
I worked for a great boss who would throw some task at me with some absurd deadline. First couple of times I protested that I couldn’t possibly get all that done in that time. He would say, “80% is good enough”. I learned he did not mean to do a half-assed job. He meant that when faced with a big job and minimal resources, you did your best and that would usually save the day. Once he said to think of the film, “55 Days at Peking,” a true story. By using their heads, a small group of defenders managed to save the day until the cavalry arrived.

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