More than 2 million covid vaccines discarded across Pa. as doses expire

A year and a half ago, as the demand for the newly released covid-19 vaccines far and away outstripped the minute supply, shot-seekers rushed clinics and fought desperate battles to snag short-lived appointment openings online.

Now, however, as demand for the vaccines falls to its lowest point, thousands of vaccines across the region are being discarded, oftentimes because they are spoiled or because there are not enough people seeking shots to use an entire vial’s worth of vaccine.

Across Pennsylvania, nearly 2.2 million vaccines have been discarded since they became available in late 2020. Some vials were broken or lost, but a majority spoiled before they could be used, according to data from the state Department of Health.

“It’s concerning in the sense that there are still a significant proportion of the population that remain unvaccinated,” said Dr. Amesh Adalja, a Pittsburgh-based infectious disease and critical care expert. “The amount of waste is emblematic of how deep the anti-vaccine movement has reached.”

About two-thirds of the U.S. population is fully vaccinated, and less than half have received a booster dose. People older than 50 and people with certain immune conditions are eligible for a second booster shot. According to the Centers for Disease Control and Prevention, only about 28.5% of those over 50 nationwide have gotten a second booster.

In Pennsylvania, about 70% of people are fully vaccinated with about 23 million doses given, according to state and federal data. About 44% have received a booster, and just over a quarter aged 50 and up have gotten a second booster.

Dr. Debra Bogen, director of the Allegheny County Health Department, called vaccine waste “an unfortunately reality in the U.S.” – including at their own county clinic.

According to state data, the health department’s immunization clinic discarded a total of 6,490 — 4,891 of which came from vials that were opened but not used in their entirety.

“We are committed to offering vaccine to anyone who wants it – even if it means we use only one or two doses from a vial,” Bogen said.

The preference, she said, is to waste no amount of vaccine, but limited demand means there are often leftover doses that go unused before they spoil.

The demand for vaccines has plummeted to the lowest level yet. Across the country, the seven-day average for vaccines administered each day was more than 3 million in late March 2021.

While the number rose sharply amid the omicron surge — an average of 1.7 million in early December — the daily average has since fallen to just over 154,000 per day.

A similar pattern has held in Pennsylvania: On April 1, 2021, about 128,000 new doses were being administered each day. As of July 1, the seven-day average was 7,076.

That’s even as the country continues to see between 120,000 to 125,000 covid cases each day, including roughly 2,800 in Pennsylvania. Hospitalizations nationwide, too, have trended upward from June to July.

With lower demand, it can be a struggle for vaccine providers to use all of the doses in a single vial.

“There’s always going to be some waste,” said Jack Moschgat, part owner of Mainline Pharmacy in Harrison City.

He said one of the keys to reducing waste would be to find a way to make the vaccine last longer once the vial has been opened. Vials of Moderna vaccine contain 20 doses. Once opened, the vaccine in a Moderna vial must be used within 12 hours, according to the CDC.

“It’d be pretty hard to get exactly 20 in one day,” Moschgat said, noting that there is less urgency with Pfizer vaccines, as there are about six doses in each vial. “A flu shot vial lasts more than one day – we can use it for 28 days. If they’re going to keep a bunch of (covid) doses in one vial, they need to make it last a week or maybe longer.”

Bogen, too, said more might be done in the future to limit the vaccines going to waste. She said that while the United States has ample supply of vaccine, other parts of the world do not.

“With time,” she said, “I hope we will reduce vaccine waste in the U.S., perhaps by switching to single-dose systems and matching supply and demand more closely.”

Some doses go to waste because of no-shows. Moschgat said about 5% of his appointments don’t show up.

The pharmacy right now is averaging about 10 to 15 booster vaccines each day, he said, noting that demand has risen in the region alongside covid-19 cases.

Moschgat’s Mainline Pharmacy topped the list in terms of discarded vaccines in Westmoreland County: Just under 12,100 total, according to state data.

Reasons for discarding vaccine fall into to one of six categories as defined by state and federal officials: Broken vial or syringe; the vaccine was drawn but not administered; the vaccine was lost or couldn’t be accounted for; the vial was opened but the vaccine was not administered; the vaccine spoiled; or “other.”

Most of the discarded vaccine fell into three of the six categories: open vial but not administered, spoilage, and “other.”

“Other,” officials said, can mean any number of things. One example, said Department of Health spokesman Mark O’Neill, is if there was not enough vaccine in the vial for a full dose.

In Pennsylvania, the pharmacy that had to discard the largest amount of vaccine was Lehigh Valley Pediatric Associates in Lehigh County, according to data from the Department of Health. Just over 77,000 vaccines were thrown out, and nearly all were because they’d spoiled.

UPMC Presbyterian has discarded nearly 10,500 vaccines, the most in Allegheny County. About 6,720 have been tossed at St. Margaret, 4,765 at UPMC Mercy and 4,739 at Children’s Hospital of Pittsburgh, data shows.

“The supply of vaccine is better now,” said UPMC Chief Medical Officer Dr. Donald Yealy, “and we remain focused on getting optimal vaccination to as many as we can.”

He noted the health system has administered more than 827,000 vaccine doses over its coverage area.

“We always avoid waste,” Yealy said, “and we carefully plan and implement ways to best serve people.”

A June report from NBC News showed that the United States has wasted more than 82 million vaccine doses, with many providers citing the declining demand.

Large chain pharmacies, predictably, have contributed the most to that total just by the sheer volume of vaccine such chains have handled.

Walmart and CVS were responsible for more than a quarter of those doses that were tossed – about 11.8 million of 89.9 million received from CVS alone, according to the report.

Officials told NBC in a statement that the focus has been on getting shots into arms on demand, even if it means the rest of a vial goes to waste.

“We often have to open a multi-dose vial at the end of the day for a single walk-in,” the company said in a statement. “Those vials have a very limited shelf life, which unfortunately means unused vaccine will be disposed of. The same challenge is faced by others administering vaccinations.”

At Palmer Pharmacy in Russellton, only about 624 vaccines have gone to waste since they became available early last year — that includes 470 that spoiled and 104 that weren’t used from an already open vial.

“You have a tendency to get a couple (doses) out of a vial,” said staff pharmacist Lorie Sarnowski, and the rest get discarded before they can be used.

Like many providers, Sarnowski said fewer people are looking for vaccines.

“We used to have days that the day was completely filled,” she said. “Now we don’t.”