Millions of surplus Covid-19 vaccine doses pile up in U.S. states as expiration dates approach

States are sitting on millions of surplus Covid-19 vaccine doses Public health officials fear the doses are going to go to waste even as countries around the world are desperate to secure their own doses. Olivia Goldhill STAT

Millions of unused Covid-19 vaccines are set to go to waste as demand dwindles across the United States and doses likely expire this summer, according to public health officials.

Several state health departments told STAT they have repeatedly asked the federal government to redistribute their supply to other countries, many of which are facing a third wave of the Covid-19 pandemic. Officials in Washington have rejected those requests, citing legal and logistical challenges.

“We’re drowning in this stuff,” said Robert Ator, a retired colonel in the Arkansas Air National Guard who is leading that state’s Covid-19 vaccine distribution drive. “It’s starting to get a bit silly and we want to make sure we’re being good stewards.”

Some of the wastage could be forestalled if U.S. health officials extend the shelf life of the vaccine developed by Pfizer, but such expiration dates can only be extended so far.

Currently, states have administered 52.36 million fewer doses than have been distributed to them, according to federal data.

Part of that vaccine gap can be attributed to reporting delays and everyday wastage, while some unused vaccine includes second doses that haven’t been administered yet. Still, even a conservative estimate suggests at least half is likely excess vaccine, said Jennifer Kates, director of global health at the Kaiser Family Foundation. That would leave 26.2 million unused doses at the state level — enough to protect at least 13.1 million people.

A significant tranche of Pfizer doses is expected to expire in August. “We’re staring down the barrel, we know it’s happening,” said Jenny Ottenhoff, senior policy director of global health and education at the ONE Campaign, the nonprofit seeking to end extreme poverty and preventable disease. Given waning domestic vaccine demand, those doses are unlikely to be fully used before they must be tossed.

“We’re seeing demand falling off across all the states,” said Marcus Plescia, chief medical officer at the Association of State and Territorial Health Officials. “It’s not like, if Connecticut doesn’t need theirs, it can go to Alabama. There just isn’t the demand.”

In North Carolina, 119,756 doses from all three vaccines authorized by the Food and Drug Administration will expire in July; an additional 854,548 is set to expire in August, and hundreds of thousands more will expire in the fall. Arkansas hasn’t accepted new orders since April, when it had 500,000 doses, and has since worked its way down to 380,000, some 100,000 of which will expire at the end of July. “We’re still chopping away at it,” said Ator. “I don’t want to waste a thing.” Delaware said 25,768 vaccines will expire in August, while Colorado has 352,533 doses that will expire in the next two months.

Meanwhile, stockpiles of vaccines continue to build at the federal level. The U.S. has bought 1.41 billion doses in total, and has so far distributed around 390 million across the country. An additional 562 million Moderna, Pfizer, and Johnson & Johnson vaccines are expected to arrive in the U.S. from July 2021 until the end of the year, according to Airfinity, a life sciences analytics firm. The White House announced plans to share 80 million doses of its supply last month, and purchased an additional 500 million vaccines for low- and middle-income countries. ...

Many states started seeking federal assistance in redistributing excess vaccine internationally in April, Plescia said, with the Covid-19 crisis flaring in India. Some wealthier states, such as New York and California, have the financial capability to arrange international transportation themselves, said Plescia. And there are plenty of vaccines close to the border, where it would be easy for providers to give supply to those in Canada or Mexico. The federal government owns these vaccines, however, and does not permit states to redistribute them. ..