Why 300 Doses of Vaccine Sat Unused in Freezers for 2 Weeks


Dr. Peter Meacher expected to receive just a small supply of Moderna’s coronavirus vaccine to inoculate his staff at a network of clinics that he oversees in New York City. Instead, 600 doses arrived late last month, far more than he needed.For two weeks, more than half of the supply sat in freezers. At other clinics in the city, small numbers of unused doses have even been thrown out.
Dr. Meacher said he would like to give the extra vaccine to high-risk patients, but had not for fear of violating strict eligibility rules from the state and city about who can receive it.
“It’s stressful and frustrating to have vaccine and to be unable to start giving it to our patients as quickly as we would like,” said Dr. Meacher, chief medical officer for the Callen-Lorde Community Health Center in Manhattan, which serves some 18,000 L.G.B.T.Q. New Yorkers.In New York City and many places around the country, the mass vaccination campaign is off to a dispiriting start, with public health experts voicing concerns about how few people have been vaccinated so far, even as coronavirus cases soar and a more contagious variant of the virus has been detected.

It initially seemed that the main bottleneck would be scarcity of the vaccine. But in New York City, health experts said the problem was that officials have been slow to make use of vaccine doses already distributed. As of early Friday, only 167,949 of 489,325 doses had been administered — about 34 percent, which was lower than the rate across New York State, which is over 40 percent.

Elsewhere, governors are setting aside strict protocols because of mounting criticism over the pace of inoculations and significant demand. The Trump administration has begun urging states to open up access, even as public health officials worry that could bring more chaos to a complicated operation and increase the likelihood that vulnerable Americans will be skipped.

Some states, including Florida, Louisiana and Texas, have already expanded eligibility for the vaccine. But in New York, Gov. Andrew M. Cuomo has stuck to rigid guidelines that prioritize health care workers, and residents and staff of nursing homes and group The slow pace has touched off new tensions between Mr. Cuomo and Mayor Bill de Blasio. The two men, Democrats with a history of feuding, have frequently clashed over the response to the pandemic.

On Friday, the mayor again called on the state to open up eligibility to larger categories, including some essential workers and people over 75.

But the governor has so far not expanded eligibility beyond that first group, saying that it was important to first vaccinate as many of those people as possible. He recently signed an executive order threatening fines of up to $1 million for health care providers who violate his prioritization system.

City officials said it would be easier to speed things up when far more people were eligible.

“Come on, give us the freedom to vaccinate,” Mr. de Blasio said on Thursday, referring to the governor.

Mr. Cuomo has said that given the scarcity of doses, it makes sense to limit eligibility.

“We owe it to them ethically,” he said, adding that health care workers needed the protection the most so that they could care for others during an escalating second wave.

Alex M. Azar II, the secretary of the federal Department of Health and Human Services, urged states this week to not allow rigid prioritization lists to slow things down.

CORONAVIRUS BRIEFING: An informed guide to the global outbreak, with the latest developments and expert advice.

“There is no reason that states need to complete, say, vaccinating all health care providers before opening up vaccinations to older Americans or other especially vulnerable populations,” Mr. Azar said.homes.He said states should not “leave vaccines sitting in freezers.”

But that is exactly what has been happening in New York City. As a result, some community clinics, like those in the Callen-Lorde system, feel they are caught in the middle of a haphazardly planned vaccine rollout. While many vaccine doses have gone to hospitals, a substantial amount have gone to smaller, nonprofit community health networks that typically treat low-income and underserved people.

At first, the clinics in these networks were limited to vaccinating their own staff. But this week, as officials tried to clear the logjam, the clinics were tasked with trying to find other eligible health care workers they could vaccinate.

ImageThe Moderna vaccine yields 10 doses, which makes planning often necessary so no doses are discarded. 
Credit...James Estrin/The New York Times
On Tuesday evening, the Family Health Center of Harlem stayed open late after scheduling vaccination appointments between 6 p.m. and 8 p.m. with more than 20 workers at a neighboring community health agency, said Dr. Neil Calman, president of the Institute for Family Health, a nonprofit health network that includes the Harlem clinic.
But some workers did not show and others decided against getting the vaccine at the last moment, Dr. Calman said. That left just 12 people willing to be vaccinated.
Vials of the Moderna vaccine generally yield 10 doses, which must be used within six hours after a vial is punctured. Not wanting to turn away two people, the clinic opened a second vial. After a quick search, the staff found three other eligible people, leaving five unused doses, Dr. Calman said.
The nurse at the clinic called her supervisor at home asking what to do with the remainder. From her home, the supervising nurse called her contact at the city’s health department for guidance. She was told to try to find someone who fit the eligibility criteria and was encouraged to contact a nearby nursing home, an urgent care center and a women’s shelter.


Continue reading the main story“There are very vulnerable patients who come to us for their care, and we want to get them the vaccine,” he said.


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