In-Depth: 126K COVID vaccine doses went to waste in California since roll-out began

More doses set to expire this summer
covid vaccine
Posted at 5:55 PM, Jul 22, 2021

SAN DIEGO (KGTV) -- More than 126,000 COVID vaccine doses have gone to waste in California since the roll-out began, a number that healthcare experts hailed as a success given the massive scale and complicated logistics underpinning the vaccination campaign.

However, looming expiration dates on a large tranche of doses this summer and lingering hesitancy could push California’s wastage rate higher, experts said.

From December through June, the California Department of Public Health recorded 126,278 wasted COVID doses, according to data obtained by ABC 10News through a public records request.

That figure includes doses that were discarded or unusable for a variety of reasons, including doses that were spoiled, expired, or left too long in an opened vial.

During that span, California distributed 47.6 million doses, meaning the wastage rate was 0.26 percent.

“That’s a true success,” said UCSF Health chief pharmacy executive Dr. Desi Kotis.

Some level of vaccine waste is normal and unavoidable. In a routine vaccination effort, the World Health Organization expects a wastage rate of 10 to 40 percent.

“That is an extraordinary feat when you put all the pieces together,” Kotis said. “These are short stability [vaccines]. They need to be tracked. They need to be under freezer or refrigerated conditions at all times.”

The most waste occurred in May when vaccine supplies surged, demand waned, and the Centers for Disease Control and Prevention began urging providers to vaccinate every eligible person, even if it meant using just one dose in a vial. Vials can hold between 5 and 14 doses depending on the manufacturer.

There were 63,866 wasted doses in May, followed by 34,478 in June, ABC 10News reported.

“We’re always concerned about using every single dose. But if a patient presents and they’re unvaccinated, at this point in time it’s our duty as health care personnel to vaccinate that person, even if we’re going to waste a few doses,” said Suzanne Shea, vice president of Pharmacy and Clinical Nutrition at Sharp HealthCare.

Each COVID vaccine vial has multiple doses. Once it is punctured, providers have just six hours to use them all, she said. That’s getting harder, with 63 percent of California adults now fully vaccinated.

Moderna doses accounted for 52.6 percent of all wastage. That’s likely because Moderna shots come in the largest vials, a CDPH spokesperson said. Each Moderna vial contains 10 or 14 doses, compared to 5 for Johnson & Johnson and 6 for Pfizer.

The nation’s most populous county, Los Angeles, wasted the most doses -- but not by much. There were 15,985 wasted doses in Los Angeles County, 12,957 in Orange, 12,745 in Riverside, 11,582 in Alameda, and 10,385 in San Bernardino.

LA County is larger than those four other counties combined.

Fifty-three of California’s 58 counties reported at least some waste. Alpine, Colusa, Calaveras, Mariposa, and Mono reported none; each has a population smaller than 45,000.

San Diego County, with the state’s second-largest population, excelled in preventing doses from going bad. The county recorded 3,227 wasted doses, placing it 13th on the list, according to an analysis by ABC 10News.

Shea of Sharp HealthCare credited San Diego County officials for working to redistribute doses to smaller clinics: “They are doing an incredible job.”

“San Diego County is helping us by literally sending us emails every single day for physician’s offices, clinics and other locations that are in need of vaccine,” she added.

But health experts said California could soon run into a different waste problem. Providers are sitting on tens of thousands of unused doses scheduled to expire this summer and fall, beginning with a significant number of Pfizer doses in August.

CDPH declined to provide an estimate of the number of doses scheduled to expire this summer. “Until providers report doses as expired, we cannot provide a figure on doses expired,” a CDPH spokesperson said.

Across the country, health officials have warned that millions of doses are at risk of expiring in the coming months.

However, the federal government has barred hospitals from sharing shots with other states or countries.

“We did talk with Chair Pelosi. We talked with the Biden Administration to try to say, ‘Hey, we don’t want these going to waste. Can we get them anywhere outside of the U.S.?” said Kotis.

So far, the answer has been no. Kotis said federal officials blocked her hospital’s attempts to share doses with countries like Mexico or the Bahamas.

“I don’t know what the holdup is,” she said.

The U.S. Department of Health and Human Services did not immediately respond to a request by ABC 10News for comment. In the past, the agency has said redistributing doses after they’ve reached providers is too legally and logistically complex, according to Stat News.

Shea said she devoted entire days to preventing vaccines from going to waste. “To see so many vaccines come up on expiration and our hands being tied to take them across the border, it’s very frustrating,” she said.

Vaccine makers are still studying the shelf life of their shots. There’s a chance the Food and Drug Administration could extend the expiration dates, something the agency did for J&J in June.

If not, vaccination providers are worried that 126,000 wasted doses in California is just the beginning.