Vaccine providers say declining demand, large minimum orders and multidose vials make it hard to avoid waste while still offering shots to anyone who wants them.
Pharmacies, states, U.S. territories and federal agencies discarded 82.1 million Covid vaccine doses from December 2020 through mid-May — just over 11 percent of the doses the federal government distributed, according to data the Centers for Disease Control and Prevention shared with NBC News. That’s an increase from the 65 million doses the CDC told the Associated Press had been wasted as of late February.
Two retail pharmacy chains, CVS and Walmart, were responsible for over a quarter of the doses thrown away in the United States in that time period, in part due to the sheer volume of vaccine they handled.
Five other pharmacies or dialysis centers — Health Mart, DaVita, Rite Aid, Publix and Costco — wasted fewer overall doses, but a higher share: more than a quarter of the vaccine doses they received, well above the national average. Two states also discarded more than a quarter of their doses: Oklahoma, which tossed 28 percent of the nearly 4 million doses it received, and Alaska, which threw away almost 27 percent of its 1 million doses, according to the CDC data.
The overall amount of waste is in line with World Health Organization estimates for large vaccination campaigns. But public health experts said the waste is still alarming at a time when less than half of fully vaccinated Americans have a booster shot — which is critical to fight newer, more contagious virus strains — and when many poorer countries continue to struggle with vaccine supply.
“It’s a tremendous loss to pandemic control — especially in the context of millions of people around the world who haven’t even been able to get a first dose,” said Dr. Sheela Shenoi, an infectious disease expert at the Yale School of Medicine.
The millions of wasted vaccine doses include some that expired on pharmacy shelves before they could be used, others that were spoiled by the thousands when power went out or freezers broke, and still others that were tossed at the end of the day when no one wanted the last few doses in an opened vial.
Unlike most other immunizations in the U.S., the coronavirus vaccines come in multidose vials, which means all the doses must be used within hours once the vials are opened — or discarded.
State health officials and pharmacies said that’s been a major contributor to vaccine waste. Some also said the vaccines come in such large minimum orders that they are left with more than they need.
Some pharmacies, including CVS and Rite Aid, said their priority has been offering the vaccine on demand. If getting a shot into an arm means opening a new vial and wasting the unused doses, that’s a tradeoff they’re willing to make.
CVS wasted nearly 11.8 million doses, or about 13 percent of the 89.9 million it received. The share of doses discarded is just above the national average, but in total still amounts to more wasted doses than any other pharmacy or state.
“We often have to open a multidose vial at the end of the day for a single walk-in,” the company said in a statement. “Those vials have a very limited shelf life, which unfortunately means unused vaccine will be disposed of. The same challenge is faced by others administering vaccinations.”
Walgreens, one of the nation’s largest pharmacy chains, wasted 8.3 million doses, or about 10.5 percent of the nearly 79.6 million doses it received.
In a statement, the company pointed to no-show appointments, cancellations and open vials expiring as reasons for the waste.
“The latest CDC guidance advises that providing COVID-19 vaccinations should be prioritized, even if it leads to vaccine waste,” the company said.
The challenge of getting shots into arms and avoiding waste has become especially difficult as demand wanes for the vaccines, experts and officials say.
“The demand has plateaued or is coming down, and that leads to open-vial wastage — especially with multidose vials,” said Ravi Anupindi, a professor of operations research and management at the University of Michigan who has studied vaccination campaigns.
“It’s a demand problem,” he added.
Nemo me impune lacessit