Pharmacists say "pooling" of leftover vaccines would provide more shots

Pharmacists say 'heartbreaking' waste of Covid vaccines has a simple solution The FDA says leftover Covid-19 vaccine cannot be combined because neither Moderna's nor Pfizer's products contain preservatives to prevent contamination. NBC News

As millions of people across the country line up for their coronavirus vaccination shots, health officials are struggling to meet the surging demand, the result of short supplies.

"It's more valuable than liquid gold, truth be told," said Melanie Massiah-White, chief pharmacy officer for Inova Health System, a nonprofit hospital network based in Northern Virginia.

Some pharmacists say a simple solution could get thousands more people vaccinated each week, but the Food and Drug Administration is standing in the way.

It's called "pooling" — and it's not a new concept. Pharmacists have been doing it for years with everything from flu vaccines to some chemotherapy medications to antibiotics. It involves taking what's left over in a drug vial and combining it with what's left in another vial to create a full dose.

"It doesn't look like a lot at the bottom of the bottle," said Dr. Stephen Jones, CEO of Inova Health System, based in Falls Church, Virginia. "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."

Pharmacists at Inova Health, one of the largest hospital systems in the Washington, D.C., area, say they started noticing significant amounts of leftover vaccine in almost every vial, even after they used the additional sixth doses in Pfizer's vials. But because of the FDA's regulations, they are being forced to throw out any extra vaccine.

"It's heartbreaking for us," Massiah-White said. "We've had multiple team members that rotate through here, and at least daily somebody says, 'Why can't we pool the waste?'"

The Inova pharmacists did an experiment, taking 100 vials that had residual vaccine. Eighty of them 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 meant that on a typical vaccination day, when the hospital will typically give more than 4,000 shots, it could give an additional 400 vaccination shots with the same supply. ...