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Some COVID-19 vaccine doses are going to waste. But just how many?

COVID-19 vaccination site
A COVID-19 vaccination site in Nashville.
(Mark Humphrey / Associated Press)
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As millions continue to wait their turn for the COVID-19 vaccine, small but steady amounts of the precious doses have gone to waste across the country.

It’s a heartbreaking reality that experts acknowledged was always likely to occur. Thousands of shots have been wasted in Tennessee, Florida, Ohio and many other states. The reasons vary from shoddy record-keeping to accidentally trashing hundreds of shots.

However, pinning down just how much of the lifesaving vaccine has been tossed remains largely unknown, despite assurances from many local officials that the number remains low.

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Waste is common in global inoculation campaigns, with millions of doses of flu shots trashed each year. By one World Health Organization estimate, as many as half of the vaccine doses in previous campaigns worldwide have been thrown away because they were mishandled, unclaimed or expired.

By comparison, waste of the COVID-19 vaccine appears to be quite small, though the U.S. government has yet to release numbers shedding insight on its extent. Officials have promised that that may change soon as more data are collected from the states.

In the interim, state health agencies are much more inclined to tout how fast they’ve administered the shots while keeping mum on the number of doses that end up in the trash.

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COVID-19 vaccination teams want to use every drop they can. Some are seeking FDA permission to create more doses by combining vaccine from two vials.

Ohio’s Department of Health resisted the use of the term “wasted” when asked by the Associated Press for a total number of tossed doses. Instead, a spokesperson for the agency said that the state tracks “unusable” vaccines reported by state providers.

“With 3.2 million doses administered as of March 9, 2021, the 3,396 unusable doses reported by state providers make up about 0.1% of the doses administered — less than the CDC expectation of 5% of unusable doses,” Alicia Shoults, an Ohio Department of Health spokesperson, said in an email.

According to a log sheet provided by the department, Ohio providers reported almost 60 incidents where doses were unused. The largest incident occurred earlier this year, when a pharmacy responsible for distributing the vaccine to nursing homes failed to document storage temperatures for leftover shots, resulting in 890 doses being wasted.

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In Tennessee, wasted, spoiled or unused doses aren’t publicly disclosed on the state’s online COVID-19 vaccine dashboard. However, after nearly 4,500 of Tennessee’s doses were ruined in February, the state’s Department of Health scrambled to find answers.

The clarification comes after reports that county policy called for opened doses to be discarded if the intended recipients didn’t keep their appointments.

It started with nearly 1,000 doses reported missing in eastern Tennessee’s Knox County, where emotional local leaders told reporters that a shipment was accidentally tossed by an employee who believed that the box contained dry ice.

Shortly afterward, slightly more than 2,500 doses were reported wasted in Shelby County, which includes Memphis. A state investigation concluded that the eye-opening spoilage was due to substandard pharmacy practices, a lack of standard operating procedures for storage and handling, disorganized record-keeping and deficient management of soon-to-expire vaccine doses.

An additional 1,000 doses were then reported spoiled in middle Tennessee after a school district acknowledged a storage error.

Despite the recent string of incidents of wasted vaccine, the Tennessee health agency stressed that the number represents a fraction of the nearly 1.9 million doses the state has received since December.

When a freezer malfunctioned, a small Ukiah hospital had to use or lose its Moderna COVID dosages quickly, becoming a case study in mass inoculation.

“We don’t believe there is a systemic issue statewide, but we’re ramping up our efforts for compliance just to be sure,” state Health Commissioner Lisa Piercey told reporters earlier this month.

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Piercey said Tennessee would soon conduct a review of its vaccine-distribution efforts to prevent future waste, and eventually hire a separate company to conduct the quality checks.

In Florida, state Surgeon General Scott Rivkees recently called for an audit after more than 1,000 doses of vaccine were reported damaged last month in Palm Beach County. When asked for the review of that audit, the state said this week it would provide those documents through a request for public records — which it was still compiling.

Like other states, Florida doesn’t regularly publish how many doses don’t end up in arms, but a spokesperson for the state health department said 4,435 doses had been reported wasted as of Monday.

Police were investigating after a Wisconsin health system said an employee admitted to deliberately spoiling 500 doses of COVID-19 vaccine.

In Louisiana, health officials give updated totals of wasted doses to reporters at the governor’s weekly COVID-19 briefing. Out of 1.2 million vaccine doses administered thus far, fewer than 1,500 had been wasted as of Tuesday, said Dr. Joe Kanter, the governor’s chief public health advisor.

Ohio’s health department reported 2,349 doses wasted or spoiled as of February. Officials stress that the wasted amount is extremely low compared to the number of doses that ended up administered to people. However, they note, that doesn’t make the situation any less upsetting.

“Here’s the bottom line: This stuff is gold,” said Julie Willems Van Dijk, deputy secretary of the Wisconsin Department of Health Services. “I think every vaccinator who touches a bottle of Pfizer, Moderna or J&J knows it. ... I’ve talked to people with these wasted vaccine, and they are heartbroken.”

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The federal government has also held off releasing numbers of spoiled or unusable doses, though it says states should report such waste in its vaccine tracker.

“We are working to figure out how to provide this data online in the future when the data [are] more complete,” Kristen Nordlund, a spokesperson for the Centers of Disease Control and Prevention, said in an email.

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