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Wasted vaccine doses in Nevada: How many, and reasons why

Updated March 1, 2021 - 1:30 pm

Fewer than 1,500 doses of COVID-19 vaccine have gone to waste in Nevada, or about 0.2 percent of the almost 743,000 doses delivered to the state as of Wednesday.

Records documenting the losses show they are often due to the challenges of administering the highly sensitive vaccine within a rigid time frame before it spoils, according to copies obtained by the Review-Journal.

“I think the story is how well our vaccinating partners in Nevada are doing at safely storing the vaccine and using it effectively,” Nevada state health official Karissa Loper said, noting the state’s loss reports exclude doses the federal government delivers directly to retail pharmacies.

The state compiles the reports from health districts, hospitals and other medical clinics administering the vaccine and provides the information to the Centers for Disease Control and Prevention.

The reports include instances of damaged vials and syringes, improper storage leading to expiration and lost or unaccounted-for vaccine.

More than 200 doses statewide went to waste after vaccination clinics ended the day with more doses than appointments, or scheduled patients did not show up. Southern Nevada Health District officials reported this week that 36 percent of appointments for second doses at health district sites have been no-shows.

Provider locations in Clark County, which have received the most vaccine, recorded wasting the greatest number of doses.

Altogether, some 900 doses went to waste here. Hundreds were destroyed because they were not administered within five days of thawing, as required.

In mid-December, 200 doses of the Pfizer vaccine meant for medical workers expired at Spring Valley Hospital. They were part of a 1,300-dose shipment that arrived already thawed and was larger than the hospital needed.

Although some excess doses were redistributed among other hospitals in The Valley Health System, the hospital was unable to reach the Southern Nevada Health District to determine if there were other organizations that could use the vaccine before it expired, hospital spokeswoman Gretchen Papez wrote in an email.

“Had the vaccine arrived frozen, we would have been able to store it and use it for upcoming clinics,” Papez wrote.

Federal and state guidance at the time was that vaccines should be administered only to health care personnel. Spring Valley Hospital officials believed they could be penalized and removed from the state’s vaccination program if they had given the doses to other individuals, Papez wrote.

State officials said they have since made it clear that vaccinators can be flexible in terms of whom they immunize if the alternative is wasting doses, a recommendation that falls in line with CDC guidelines.

“We’re not imposing any penalties for using doses that would otherwise expire,” said Loper, deputy chief of Nevada’s Bureau of Child, Family, and Community Wellness.

The incident at Spring Valley Hospital occurred in the first week of vaccine distribution of the Pfizer vaccine, which requires ultra-cold storage. The state shipped the vaccine to four locations, then had to unpack, thaw, and redistribute it to every hospital across the state, Shannon Litz, a spokeswoman for the Nevada Department of Health and Human Services, wrote in an email.

Vaccine had to be “packed into containers of smaller dose increments, and driven by state or local health district staff to the final vaccinating site,” Litz wrote. “This all had to happen in a five-day time frame with a brand-new vaccine that must be handled delicately, and some doses could not be used in this time frame.”

The Southern Nevada Health District also has had to discard almost 300 doses in total, state records show. This was “due to errors including vaccine being overdrawn (in syringes) and doses set to expire not being first used at clinics,” agency spokeswoman Jennifer Sizemore wrote in an email.

Mesa View Regional Hospital in Mesquite lost 200 doses to a “storage and handling error” in early February, state records show. Hospital spokesman Robert Fuller wrote in an email that the doses “were not stored at optimal temperature during our standard reconciliation process” and were discarded per the advice of state health officials.

Rural county doses

Rural counties, which have received far fewer doses of vaccine due to their smaller populations, also have lost hundreds of doses.

Pershing and Nye counties each had to return 100 doses that arrived compromised and needed to be replaced, state records show.

Elko County has wasted the second greatest number of doses, more than 150 doses were lost. Most were due to a single incident.

In January, Northeastern Nevada Regional Hospital lost an entire 100-dose box of the Moderna vaccine after it was refrozen in a cooler after being thawed for administration, according to state records.

Hospital spokesman Steve Burrows declined to answer specific questions about the incident. He wrote in an email that hospital officials “regret the unfortunate situation that occurred and immediately put additional protocols and staff training in place.”

State and local health officials give regular training to vaccine providers on proper vaccine storage and handling, Litz said. She added the incidents leading to expired doses do not indicate a “significant pattern among providers.”

“These were self-limited events and the providers involved have received technical assistance and retraining on the storage and handling protocols,” she said.

Other states across the country also have wasted less than 1 percent of their vaccine doses, state health departments have reported. In Georgia, it’s about 0.2 percent; in Texas, less than 0.1 percent; and in Indiana, less than one-hundredth of 1 percent, according to media accounts.

A CDC spokeswoman could not provide an overall percentage of wasted vaccine for the U.S.

“We are working to figure out how to provide this data online in the future when the data is more complete,” spokeswoman Kristen Nordlund said in an email.

Contact Michael Scott Davidson at sdavidson@reviewjournal.com or 702-477-3861. Follow @davidsonlvrj on Twitter. Contact Mary Hynes at mhynes@reviewjournal.com. Follow @MaryHynes1 on Twitter.

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