UPDATE: After declining on Monday to provide vaccine wastage details for this story, the Virginia Department of Health released some information on Tuesday following publication.
State officials say they’re confident that no COVID-19 vaccines are going to waste in Virginia.
But seven weeks into the state’s vaccine rollout, the Virginia Department of Health won’t release data on wastage, which vaccinators are required to report under a provider agreement distributed by the federal Centers for Disease Control and Prevention.
The document, which providers must fill out in order to administer vaccines, requires them to report the number of doses that were “unused, spoiled, expired, or wasted as required by the relevant jurisdiction.” In practice, that means hospitals, pharmacies and other administrators should be reporting the data to VDH, which then passes the information onto the CDC.
The Mercury first requested the data from VDH in late January, after Dr. Danny Avula, the state’s vaccine coordinator, stated in a telebriefing that the reporting was required but that he didn’t have information on wastage in Virginia.
“I’ll have to look that up and pull those numbers for you,” he told reporters. “I’ve heard some anecdotal stories where you have a clinic and you’ve opened a vial and there are a few doses that people aren’t showing up for. I don’t know how rampant that is.”
Avula is one of several state health officials who have previously stated there’s no indication that the time-sensitive vaccines — which expire after five days of refrigeration in the case of Pfizer’s and 30 days in Moderna’s — have spoiled or gone unused. The Mercury requested the data after the telebriefing and did not immediately receive a response from VDH.
The Mercury also requested the data from the CDC, which referred an inquiry back to the state health department.
After following up with VDH on Monday, agency spokeswoman Melissa Gordon responded that “from discussion with our data visualization team, we do not have that data available at this time.” She did not reply to a follow-up email asking why the data was not available.
Vaccine wastage has been a concern across the country, but questions have been particularly pointed in Virginia, where health officials have struggled to account for thousands of unadministered doses (though the state has boosted its rate of vaccination since the early days of the rollout). As of Monday, the state had received 1,318,850 total doses and administered 843,230, according to VDH’s public vaccine distribution dashboard.
The department recently expanded its reporting to show which providers are getting shipments and how many doses they’ve received. But even with enhanced transparency, there are problems with the data.
During a Monday meeting of the state’s Vaccine Advisory Workgroup, Avula said many of the doses shipped to health systems were redistributed to other providers, accounting for apparent discrepancies on the dashboard (VDH reports that medical practices, for instance, have received 14,325 doses but administered nearly 66,000).
“The way that the CDC managed their inventory did not accurately track all that,” he said. “So, what we’re manually doing is working through where did the vaccine originally go and where did they distribute it to, and making sure that’s reflected in the numbers here.”
Given Virginia’s difficulties in tracking down doses, it’s unclear if the state is cataloguing wastage or consistently requiring reports from providers. ProPublica has reported that many states, including neighboring Maryland, have failed to log unused or wasted vaccines despite the CDC’s mandate.
There is some evidence that wastage could be occurring at some of the state’s vaccination events. In an email on Jan. 20, a regional CVS manager reminded employees that extra vaccine from the pharmacy chain’s long-term care clinics in Virginia shouldn’t be used outside those settings.
“New guidance is not to utilize ‘left over vaccine’ after clinics unless the person receiving can come to clinic location,” he wrote. “These vials with doses left will be waste, so even more of a reason not to dilute any vaccine we will not use in the clinic.”
CVS spokeswoman Tara Burke later said the email was referring to punctured vaccine vials that can’t be transferred from the vaccination site, according to CDC regulations.
“In the rare instance that doses have reached their expiration they are disposed of per CDC and manufacturer guidelines,” she wrote. Without state data, it’s not clear how often that occurs, either at long-term care clinics or anywhere else in Virginia.