PORTLAND, Maine — The Maine CDC issued new guidance Tuesday to instruct COVID-19 vaccine clinic staff what to do with doses that remain in vials that would otherwise have to be thrown away.
Maine CDC Director Dr. Nirav Shah explained Thursday that once a provider punctures the vial with a needle, that vial of vaccine must be completely used within six hours, or discarded.
Currently, Maine's phased approach to vaccine administration only deems people in Phase 1A and those Mainers age 70 and older as eligible for a shot.
"A wasted dose is a dose in a vial that has already been punctured where there are literally hours or minutes on the clock," Dr. Shah said. "It may not be feasible to find someone 70 or older within that six-hour window to use up that one dose that is remaining in the vial at the end of the day."
For example, a Moderna vaccine vial has five doses in it. If hypothetically, six people remain in line at a clinic at the end of a day, clinic staff will open a new vial to vaccinate that final patient, theoretically leaving four doses that would expire and be tossed.
"Are you going to tell that sixth person, 'sorry, we're not going to vaccinate you because doing so would involve opening up a vial and we're not going to do that?'" Dr. Shah said.
He said clinic staff has been able to plan and be proactive in the case of extra doses.
"They know that they have X number of people scheduled. They know they're going to need Y number of vials, and thus that there will be a certain number of doses leftover, and early in the day, they start calling folks," Dr. Shah said. "The other thing they're able to do is meter these things out at the end of the day. So they're only literally opening the bare number of vials that are needed."
The state's "Efficient and Full Use Policy" outlines the order in which vaccine clinic staff should attempt to administer any remaining doses of vaccine that is at risk of being thrown out.
"Maine’s goal is that no dose goes to waste. As such, approved sites may, without additional approval, use the small fraction of doses available at the end of a clinic to vaccinate, in this order:
• Eligible individuals age 70 and older who may be on a waiting list or scheduled at a future date, including “same day” waiting lists
• Individuals age 65 to 69; and/or
• Vaccine clinic staff and volunteers, in oldest age order, who have not otherwise been vaccinated, including calling people back if there are extra doses.
Individuals who receive a first dose specific to implementation of this policy must be scheduled for the second dose, as applicable, at the same location. The second dose should not be part of the full use management policy process for the day."
Dr. Shah said these situations are rare.
NEWS CENTER Maine requested data from the Maine CDC about the number of vaccine doses that have been discarded or expired.
A Maine CDC spokesperson responded with the following statement:
"Maine CDC has not received reports of significant amounts of discarded or expired doses. “Don’t waste a single dose” is a prime directive to vaccinators, who are expected to have plans in place to summon nearby Maine residents in phase 1a and 1b to be vaccinated if any doses remain at the end of a clinic. We have found this to be an effective way to prevent loss of doses, given the limited weekly allotments from Operation Warp Speed."