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How Should Pharmacies Handle Extra Doses of COVID-19 Vaccine?

Slate: “…Since the Pfizer and Moderna vaccine rollout began in December, there have been reports across the country of providers ending up with vaccine doses they need to use up right away. In some cases, this results from vials containing “extra” doses—for instance, each Pfizer vaccine vial is designed to hold five doses, but many contain six, and Moderna vials are designed to hold 10 but many contain 11. In other cases, like what appears to have happened at Safeway the night Ruskin received her vaccine, providers must thaw a certain number of vaccine vials for daily appointments, but people who make those appointments may not show. Whether doses are “extra” or “leftover,” these situations require providers to make quick decisions about what to do with them; unthawed doses are only good for a few hours at room temperature. Amid an already chaotic vaccine rollout, it appears there’s little official guidance on what providers should do with these doses. In some cases, policies—or confusion over how to comply with them—have led to doses thrown away. After Stat reported in early December that one in six doses of the Pfizer vaccine were discarded because it was unclear whether “extra” doses in vials were usable, the Food and Drug Administration issued official guidance clarifying that those doses could indeed be used. And in some areas of the U.S., local and state public health guidance requires providers to use extra doses on groups eligible for vaccination, leading some providers to throw away doses if they can’t find people from those eligible groups. In a particularly dispiriting account published in the New York Times, a nurse called a nursing home, an urgent care center, and a women’s shelter and even ventured out on foot to administer vaccines at those locations, but ultimately, doses still went to waste…”

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