Leftover Doses of Vaccine Raise Some Troubling Issues

Even the staff of ACSH isn't old enough (1) to have watched the Keystone Kops debut in 1912. If you've never seen this classic slapstick comedy, which about a thoroughly inept bunch of cops (not unlike the Three Stooges on steroids), here's a hilarious Youtube video compilation.

I suspect I'm not the only one with the Kops on my mind. Or the Stooges. Anyone following the clown show, also known as our "vaccination program," may be thinking the same thing—what a mess.

Although it is a multifactorial (2) mess, let's focus on one facet – leftover doses. The title of a new article by Andrea Michelson in Business Insider – "People are randomly getting vaccinated at pharmacies because of extra doses that need to be used before they expire" – pretty much says it all. On the surface, leftover doses may sound like a good problem to have, but it's really not.

Unfortunately, this is just another symptom of our supernaturally incompetent "rollout." It is difficult to imagine that anyone might think that it has been anything but a massive cluster####. Here's why.

Most of the problems described in Michelson's article involve Pfizer-BioNtech's vaccine since it has to be kept frozen at a very low temperature and then thawed before use. But the Moderna vaccine is also involved; it must be kept cold even though it is considerably more stable in standard freezers and refrigerators. 

There is no national, let alone coherent, policy for how to get needles in people's arms. Instead, in place is a hodgepodge of different "policies" individually cobbled together by hospitals, pharmacies, states, and even individual counties. They are making it up as they go along. In some places, people are waiting in very long lines only to find that the vaccine has run out. Not enough people show up in other places, and there are leftover doses in the vial (the Pfizer vaccine contains five doses). Now what? Don't ask. No one knows.

Some rather disconcerting examples from the Business Insider article:

• Thawed, unused doses are being thrown out.
• Or, they are offered to people who are not yet on the eligibility list, for example, pharmacy workers and some lucky people who happened to be standing in the right place at the right time.
• Some of the lucky individuals included an elderly couple who got a phone call from a friend who informed them that Walgreens's had extra doses.
• A law student in a supermarket was approached by the pharmacist, who had an extra dose. The student, who is very unlikely to become seriously sick or die without the vaccine, got the extra dose.

These examples raise some interesting questions:

• Will the twenty-something student who hit the supermarket sweepstakes be able to get his second shot three weeks after the first (Pfizer's protocol) even though he/she won't be on the eligibility list for months?
• Will random injections screw up record-keeping? How will those keeping records know that the student must get the second shot even though he or she is at the back of the line? 
• If not, how much protection will the student get from one dose? Will he/she become an asymptomatic carrier having received only one shot and possibly make matters worse? 
• Rumors travel fast. Will crowds of people who are not yet scheduled start to hang around pharmacy counters, etc., hoping that they get similarly lucky?
• The Pfizer/BioNtech vaccine, once thawed and diluted, is stable for only six hours in the refrigerator. It cannot be refrozen. If faced with the choice of throwing out a precious dose or waiting a little while longer for one last "customer," what will the pharmacist do?
• Will younger, healthy people be vaccinated before 80-year-old men? This would be a medical abomination.

Finally...

• Is this any way for a supposedly advanced, educated country to respond to what is arguably the worst public health crisis in a century?

No, it's not. At this time, our vaccination program is little more than a clown show—a real Bozo Bonanza. 

Pathetic.

NOTES:

(1) Barely

(2) Never use a short word when a long one will do. It makes you seem smart.