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They're A Precious Commodity, So Why Are Some COVID-19 Vaccines Going To Waste?

The Pfizer-BioNTech COVID-19 vaccine, like the Moderna version, requires storage in extremely frigid temperatures before its thawed out for use.
The Pfizer-BioNTech COVID-19 vaccine, like the Moderna version, requires storage in extremely frigid temperatures before its thawed out for use.

Amesh Adalja of Johns Hopkins University says strict guidelines around how to roll out the vaccine have discouraged health care providers from giving spare doses to noneligible groups.

COVID-19 vaccines are one of the nation's most precious commodities right now. Yet in many cases across the country, expiring doses have gone to waste.

Just last week, for example, the Ohio Department of Health suspended a vaccine provider in Columbus after nearly 900 doses spoiled before they could reach residents in long-term care facilities.

It's hard to know exactly how many doses are being thrown out across the country, but Amesh Adalja, an infectious disease specialist at Johns Hopkins University, said strict guidelines around vaccine eligibility are causing surplus doses to be discarded.

When the U.S. first rolled out its vaccination distribution effort, the federal government urged states to reserve initial doses for select population groups — primarily front-line health care workers and nursing home residents. Complicating logistics, both the Moderna and Pfizer vaccines require storage in ulta-cold temperatures, and must be used or thrown out within six hours after a thawed vial has been opened.

"There was nervousness amongst people, if they weren't able to vaccinate everybody that day and they had leftovers, that they didn't know what to do with those doses," Adalja said in an interview with NPR's All Things Considered.

He pointed to executive orders issued by New York Gov. Andrew Cuomo, who had threatened heavy fines, the revocation of medical licenses, even criminal penalties, to anyone who administered vaccines outside of the state's distribution guidelines. He's since widened the eligibility requirements.

"If people are dogmatically sticking to these priority groups ... I think that's the wrong approach," Adalja said.

One reason for the excess vaccine supplies at health care facilities, Adalja said, is because it's "very common" for people to miss their scheduled dose.

In Boston, the Dana-Farber Cancer Institute told staff in an email obtained by NPR that because many people were failing to show up for their shots, "prepared doses may be wasted."

Some hospitals have come up with solutions for vaccine waste by sending shot reminders or drawing up waiting lists to have patients on standby for potential extra doses.

"They're really getting flexible and trying to stretch the supply as best they can and avoid any kind of waste, because a vaccine in an arm is always going to be better than a vaccine in a trash can," Adalja said.

As he also noted, people eager to get inoculated linger around vaccination sites for that very reason.

"Vaccine scavengers," as he referred to them, "they're actually helping to avoid waste because they're ready to go."

He thinks that the country's sluggish vaccination rollout has gotten more efficient – but doesn't credit either states or the federal government for that.

"It has less to do with the distribution, but [health care workers] becoming innovative," he said.

For example, health care workers in Oregon on Tuesday got resourceful with expiring vaccine doses. A team of Josephine County Public Health staff was driving back from a vaccination event when an accident halted traffic during a snowstorm. Josephine County Public Health Director Michael Weber realized it would be hours before his staff could reach a clinic in time to use the remaining batch of vaccines.

So, Weber and his staff turned the highway into a makeshift vaccine center: Bearing vaccination documents and proper medical equipment, they went door to door to stranded drivers to administer the six Moderna doses they had left to willing participants.

Vincent Acovino and Christopher Intagliata produced and edited the audio for broadcast. Emma Bowman adapted it for the Web.

Copyright 2021 NPR. To see more, visit

Ari Shapiro has been one of the hosts of All Things Considered, NPR's award-winning afternoon newsmagazine, since 2015. During his first two years on the program, listenership to All Things Considered grew at an unprecedented rate, with more people tuning in during a typical quarter-hour than any other program on the radio.