While millions of people across the country line up for coronavirus vaccine shots, healthcare professionals are struggling to meet the growing demand, the result of a shortage of supplies.
“It’s more valuable than liquid gold, to be honest,” said Melanie Massiah-White, chief pharmacist for Inova Health System, an ideal hospital network based in Northern Virginia.
Some pharmacists say that a simple solution can get thousands more people vaccinated every week, but the Food and Drug Administration stands in the way.
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“It does not look like much at the bottom of the bottle,” said Dr. Stephen Jones, CEO of Inova Health System, based in Falls Church, Virginia. “But in the end it adds up to many doses that end up being wasted, and we are not allowed to use the extra vaccine. But there are times when there is almost a full dose at the end of the vial, which is heartbreaking. to let it go to waste. “
Pharmacists at Inova Health, one of the largest hospital systems in the Washington, DC area, say they began noticing significant amounts of residual vaccine in almost every vial, even after using the extra six doses in Pfizer’s vials. However, due to FDA regulations, they are forced to throw out extra vaccine.
“It’s heartbreaking for us,” Massiah-White said. “We’ve had several team members rotate through here, and at least every day someone says, ‘Why can’t we collect the waste? “
The Inova pharmacists did an experiment and took 100 vials that had the remaining vaccine. Eighty of them had significant quantities left over. The pharmacists found that with the vaccine left in the 80 vials, they could make 40 extra full doses. This meant that on a typical vaccination day, when the hospital will usually give more than 4000 shots, it can give another 400 vaccination shots with the same supply.
“If we can just start putting them together and using them immediately, we will increase the amount of vaccines that are available for free,” Jones said.
Experts say it is a simple process that pharmacists have been doing for years.
If one vial becomes contaminated, this method may spread contamination to the others, prolonging the presence of the pathogen and increasing the potential for disease transmission.
“It’s a common practice you see in vaccines,” said Stefanie Ferreri, head of the practice development and clinical education division at the University of North Carolina’s Eshelman School of Pharmacy. She said only vaccines from the same batch number should be collected so that clinicians can track where they came from if there are any problems, such as unusual side effects.
Although common, the FDA says that pharmacists and other clinicians cannot collect the remnants of Covid-19 vaccine because neither Moderna nor Pfizer’s products contain preservatives, which help stop microbial growth in case the vaccine is contaminated. bacteria or other bacteria.
“This is an infection control measure,” an FDA spokeswoman said in a statement. Cross-contamination of multiple-dose drugs using the same needle and syringe has occurred with other drugs when this procedure was used, causing severe bacterial infections. If one vial becomes contaminated, this procedure may spread contamination to the others, prolonging the presence of the pathogen. and increase the potential for disease transmission. “
But pharmacy experts say that the risk of cross-contamination is low, and that the benefits of having multiple doses far outweigh any risks.
“If the vial is not used immediately, the risk of contamination is higher because there is no preservative in the vial,” Ferreri said. “If the vial is used immediately, with a new vial of the same batch number, the risk of contamination is extremely low.”
Inova healthcare professionals say that all doses are used almost immediately in large vaccination clinics like theirs, and that they already have protocols to protect against any form of cross-contamination.
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“We would use these doses within 60 minutes,” Massiah-White said. “They will not sit. They will not reach room temperature. We would be able to get these shots in the arms very quickly here in our clinic.”
But for now, the vaccination process is still a waiting game while Americans wait for the shots and that vaccine manufacturers increase production to meet the ever-increasing demand.
“Finally, when there are enough vaccines, it will not matter to throw someone away,” Jones said. “But right now we’re millions of doses short. So a few extra doses from each set of vials will make a difference in literally hundreds of people a day.”