As millions of Americans across the country get their chance to get the Covid-19 vaccine, health officials are still struggling to meet the rising demand, due to lack of supplies.
“It’s worth more than liquid gold, ‘says the truth,’ said Melanie Massiah-White, chief pharmacist at Inova Health System, a nonprofit hospital network in Northern Virginia.
Some pharmacists believe that there is a simple solution that can get thousands of people vaccinated a week, but the Food and Drug Administration stands in the way.
This is called ‘pooling’ – and it’s not a new concept. Pharmacists have been doing this for years with everything from flu vaccine to some chemotherapy medications to antibiotics. It involves taking the excess in a medicine glass and combining it with what is left in another vial to create a full dose.
“It doesn’t look like much in the bottom of the bottle,” said Dr. Stephen Jones, CEO of Inova Health System, in Falls Church, Virginia, said. ‘In the end, it’s a lot of wastes that are wasted, and we are not allowed to use the additional vaccine. But sometimes there is almost a full dose at the end of the vial, which is heartbreaking to let it go. ‘
Pharmacists at Inova Health, one of the largest hospital systems in the Washington, DC area, say they started noticing significant amounts of residual vaccine in almost every vial, even after using the additional sixth dose in Pfizer’s vaccine. But due to FDA regulations, they are now forced to throw out any extra vaccine.
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“It’s heartbreaking for us,” Massiah-White said. “We’ve had several team members turn around here and at least daily someone says, ‘Why can’t we take the waste with us?’
The pharmacists from Inova did an experiment with 100 vials that had leftover vaccination. Of these, 80 had significant amounts left over. The pharmacists found that with the vaccine left in the 80 vials, they could make 40 additional full doses. That means on a typical vaccination day, when that hospital will usually give more than 4,000 shots, they can give 400 extra vaccines with the same supply.
“If we can simply start compiling it and use it right away, we will increase the amount of free vaccinations,” Jones said.
Experts believe it is a simple process that pharmacists have been doing for years.
If one vial becomes infected, this practice can spread contamination to another, which prolongs the appearance of the pathogen and increases the possibility of transmission of diseases.
“This is a common practice you see in vaccines,” said Stefanie Ferreri, chair of the division for practice advancement and clinical education at the Eshelman School of Pharmacy, University of North Carolina. She said only vaccines of the same lot number should be put together so clinicians can track where they come from if there are problems, such as an unusual side effect.
Although it is a common practice, the FDA says that pharmacists and other clinicians cannot combine the remaining vaccine Covid-19 because Moderna or Pfizer products do not contain preservatives, which help stop the growth of microbes if the vaccine is infected with bacteria or other germs.
“This is an infection control measure,” an FDA spokesman said in a statement to NBC News. ‘Cross-contamination of multidose drugs using the same needle and syringe occurred with other drugs when this use was used, causing severe bacterial infections. If one vial becomes infected, this practice can spread contamination to the other, which prolongs the application of the pathogen and increases the possibility of transmission of diseases. ”
But pharmacist experts say the risk of cross-contamination is low and that the benefits of more doses of Covid vaccine outweigh any risk.
“If the vial is not used immediately, the risk of contamination is greater because there is no preservative in the vial,” Ferreri said. “If the vial is used immediately, with a new vial with the same lot number, the risk of contamination is very low.”
Inova health officials say that at large vaccination clinics like theirs, all doses are used almost immediately, and that they already have protocols to protect against any form of cross-infection.
“We will use the doses within 60 minutes,” Massiah-White said. “They are not going to sit down. They are not going to get to room temperature. We could get these shots here in our clinic very quickly. ”
But for now, the vaccination process remains a wait-and-see game, as Americans in turn wait for the shot and for vaccine producers to increase production to meet the ever-growing demand.
“Ultimately, if there are enough vaccines, it will not matter,” Jones said. “But now our millions of doses are short. So a few extra doses of each set of vials will make a difference in literally hundreds of people a day. ‘