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How thousands of scarce Covid shots could be wasted

Pharmacies that have to administer many of the shots are concerned about waste, and state and local health departments say they need more money and guidance from the federal government. The federal health department says states have what they need and that the government will stop the shortcomings that arise.

“We really do not want to lose a drop of these things, so it’s a concern. And I do not have all the answers on how to do this yet, ”said Paul Cieslak, Oregon’s Medical Director of Infectious Diseases and Vaccinations.

If the vaccine is expected to be given first to healthcare professionals and the elderly, further complicating planning efforts.

Most of the concern stems from the requirements for the Covid-1

9 vaccine, which Pfizer submitted for FDA review on Friday. It must be stored in extremely cold conditions and sent in specially designed pizza-shaped boxes containing at least 975 doses in 195 vials. Once a vial is thawed and diluted to five shots, healthcare workers will be in a real “use it or lose it” situation: If there are not enough people ready for shots within six hours destroy the vaccine, slowing down efforts to eradicate hot spots and save lives.

“It would not be acceptable,” said Douglas Hoey, executive director of the National Community Pharmacists Association. “Especially early it will be almost liquid gold.”

Some waste is inevitable in any major vaccination program. But this is not the seasonal flu: Every Covid-19 vaccine cleared for use lands during a devastating global pandemic that has nearly killed 1.4 million people worldwide – including over a quarter of a million in the United States – with no sign of stopping. With analysts predicting that it could take months to vaccinate all Americans, minimizing waste will be crucial.

The earliest vaccinations will be concentrated in hospitals, federal health officials say. Even they could fight to minimize the number of spoiled doses as they vaccinated staff. But the waste problem will the loom is larger when pharmacies are gradually added to the mix – especially in rural areas where there are fewer people.

Maryland health officials told the Centers for Disease Control and Prevention that as much as 5 percent of the vaccine awarded to the state could be destroyed and left unused.

Some rural counties may not be able to use up to 975 doses alone Kurt Seetoo, who manages the State Health Department’s Center for Immunization. Maryland is exploring the creation of regional clinics and bringing together high-priority groups from different rural counties to vaccinate at once.

HHS Secretary Alex Azar told Sirius XM on Friday that Pfizer’s more challenging storage requirements make it better suited to larger institutions such as hospitals and large retail pharmacies. Another Covid-19 vaccine manufacturer, Moderna, will soon apply to the FDA for emergency approval of its shot – which can be stored in the refrigerator for up to 30 days and at room temperature for up to 12 hours.

Earlier this week, General Gustave Perna, who heads Operation Warp Speed, said the Trump administration’s initiative to bring a vaccine to market, CVS and Walgreens know how to do this, and that his team has worked with states to “make sure no vaccine is spilled.”

But Paul Offit, a vaccine researcher at Children’s Hospital of Philadelphia and a member of the expert panel that advises the FDA on Covid-19 vaccines, told reporters Friday that he is “very concerned” about the possibility that doses of Pfizer’s vaccine would be wasted if it’s approved.

“This is going to be very hard, I think there will be a steep learning curve here,” Offit said. “I think there will be a lot of waste and I think we will find out about this over time. There is going to be a lot of stumbling. … You have six hours once reconstituted, it is unprecedented. ”

In Oregon, the state may be able to contract with emergency medical providers to drive around and immerse the vaccine between remote areas – an attempt to avoid having residual shots.

And North Dakota wants to repackage the vaccine in boxes with smaller quantities, while urging providers to be able to quickly identify people in the next priority group to come and get a shot if there is any vaccine left. The state is also asking facilities to pre-register patients to ensure no vaccine is thrown away. Its vaccine plan recognizes that this can delay distribution by a day, but it is necessary to preserve precious vials. Pfizer says they are working on a smaller pack size, but it will not be ready until early next year, and it is unclear if that will solve the need to deliver at least five shots within a few hours.

The various plans underscore the concerns that public health experts have long raised about the practical approach that the Trump administration has maintained throughout the pandemic. It has been true, even for the last leg of the vaccine race, that the president has made the center of his coronavirus response.

“There’s a huge management vacuum,” said Georges Benjamin, executive director of the American Public Health Association.

Meanwhile, the Trump administration refuses to share its planning with the transition team of President-elect Joe Biden, who said Wednesday that the lack of access could hamper vaccine distribution. Instead, Biden’s team has been in contact with Pfizer and other drug manufacturers; a Pfizer spokesman refused to share the details of the communication.

“There is no excuse for not sharing the data, and let’s start planning,” Biden said Thursday during a news conference. “If we do not have access to all this data, it will put us behind the eight bullets in a month or more. And that’s life. ”

Azar disputed the claim Friday on CBS ‘”This Morning” and said it was “absolutely wrong.”

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