Allowing pharmacists to pool COVID-19 vaccine left over in vials could allow providers to vaccinate thousands more people per week, pharmacy experts told NBC News Feb. 22.
Pooling vaccines means taking what is left over in a vial and combining it with what's left in another vial to create a full dose. Pharmacists typically do this with flu vaccines, some chemotherapy drugs and antibiotics, NBC News reported.
"It doesn't look like a lot at the bottom of the bottle. But ultimately, in aggregate, that adds up to a lot of doses that end up being wasted, and we're not allowed to use that additional vaccine. But there are times where there's almost a full dose at the end of the vial, which is heartbreaking to let that go to waste," Stephen Jones, MD, CEO of Falls Church, Va.-based Inova Health System, told NBC News.
Pharmacists at Inova Health System told NBC News that there are significant amounts of vaccine left over in almost every vial, even after extracting an extra sixth dose from Pfizer's vials.
The FDA doesn't allow providers to pool COVID-19 vaccines. An agency spokesperson told NBC News that because neither Moderna nor Pfizer's vaccines contain preservatives that help stop microbial growth in case the vaccine is contaminated with bacteria or other germs, not allowing pooling of the vaccines is an infection control measure.
"Cross-contamination of multidose medications through the use of the same needle and syringe has occurred with other medications when this practice was utilized, causing serious bacterial infections. If one vial becomes contaminated, this practice can spread contamination to the others, prolonging presence of the pathogen and increasing the potential for disease transmission," the spokesperson said.
But pharmacy experts told NBC News the risk of cross-contamination is low because the vials would be used right away, and they would only pool vaccines from the same lot. They argue that the benefit of having more doses far outweighs any risk. By only pooling vaccines from the same lot, providers could track where they came from if there were any issues, such as unusual side effects.
Pharmacists at Inova Health System conducted an experiment and found that 80 vaccine vials had enough leftover vaccine that they could make 40 more doses, NBC News reported. On a typical day, when the hospital would give more than 4,000 shots, it could give an additional 400 shots with the same supply if allowed to pool the leftover doses, according to NBC News.
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