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Pharmacists say combining leftover COVID-19 vaccine could increase daily shots by 10%


Pharmacists say that combining leftover COVID-19 vaccines from different vials could save thousands of doses.

The process, called ‘pooling,’ involves taking residual vaccine left behind in one bottle and amalgamating it with a little bit from a second bottle to create one full dose. 

One pharmacy team at Inova Health System, a nonprofit hospital network in Fairfax, Virginia, told NBC News that if it was allowed to mix remaining vaccines from different vials, it could administer 10 percent more doses every day.

However, the U.S. Food and Drug Administration (FDA) does not allow pooling because neither of the vaccines approved in the U.S. contain preservatives, which prevent contamination with bacteria or fungi.

Pharmacists at Inova Health System, a nonprofit hospital network in Fairfax, Virginia, say they found that they could combine the leftover vaccine from 80 vials to create an extra 40 full doses. Pictured: Walmart pharmacist Carmine Pascarella draws a dose into a syringe from a vial of the Moderna vaccine in West Haven, Connecticut, February 17

Pharmacists at Inova Health System, a nonprofit hospital network in Fairfax, Virginia, say they found that they could combine the leftover vaccine from 80 vials to create an extra 40 full doses. Pictured: Walmart pharmacist Carmine Pascarella draws a dose into a syringe from a vial of the Moderna vaccine in West Haven, Connecticut, February 17

This means the clinic, which typically administers 4,000 doses, could give out 400 additional shots, an increase of 10% daily as the U.S. vaccinates 1.3 million people per day

This means the clinic, which typically administers 4,000 doses, could give out 400 additional shots, an increase of 10% daily as the U.S. vaccinates 1.3 million people per day

The FDA does not allow pooling because no COVID-19 vaccines contain preservatives, which prevent contamination with bacteria or fungi, but pharmacists say the benefits of increasing supply outweigh the risks

The FDA does not allow pooling because no COVID-19 vaccines contain preservatives, which prevent contamination with bacteria or fungi, but pharmacists say the benefits of increasing supply outweigh the risks

Pharmacists told NBC News that pooling is a concept that has been used for other types of medications, such as flu shots and chemotherapy drugs.  

‘It doesn’t look like a lot at the bottom of the bottle,’ Dr Stephen Jones, CEO of Inova Health System, told the network. 

‘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.’

In January, Pfizer Inc and its German partner BioNTech SE revealed that each of its vials actually contains six doses instead of the initial five. 

However, even after extracting that sixth dose, pharmacists at Inova Health saw residual vaccines in vials of both Pfizer and Moderna.

So the team decided to perform an experiment.

They told NBC News that they took 100 vials that still had leftover vaccine and found that 80 had a ‘significant amount.’

By combining the remaining liquid, they were able to have an extra 40 full doses. 

Most days, Inova Health administers 4,000 doses. That means the clinic could be giving out 400 additional shots, an increase of 10 percent.

‘If we can simply start putting them together, using them immediately, we’ll increase the amount of vaccines available for free,’ Jones told NBC News.

However, the FDA says it does not allow clinicians to pool leftover coronavirus vaccines because neither the Pfizer jab nor the Moderna shot were made with preservatives that would prevent the growth of bacteria or fungi if any vials accidentally became contaminated.

‘This is an infection control measure,’ an FDA spokeswoman told NBC News in a statement. 

‘Cross-contamination of multi-dose 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.’

But pharmacists say the benefit of boosting supply far outweighs the risks of potential contamination.

An average of 1.3 million people are being vaccinated every day and they say increasing the amount of doses available could help President Joe Biden more quickly reach his goal of 100 million shots in 100 days.

‘We would use those doses within 60 minutes,’ Melanie Massiah-White, chief pharmacy officer for Inova Health, told NBC News.

‘They’re not going to sit. They’re not going to come to room temperature. We would be able to very quickly get those shots into arms right here in our clinic.’  



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