US hospitals discover a surprise in their vaccine deliveries: extra doses

Some vials supposed to hold five doses actually contained six, or seven

A health care worker at UCI Medical Centre in California displays a vial of the Pfizer-BioNTech Covid-19 vaccine. Photograph: The New York Times

A health care worker at UCI Medical Centre in California displays a vial of the Pfizer-BioNTech Covid-19 vaccine. Photograph: The New York Times


As boxes of Pfizer vaccines began arriving around the US this week, hospital pharmacists made a surprising discovery: some of the glass vials that are supposed to hold five doses contained enough for a sixth – or even a seventh – person.

The news prompted a flurry of excited exchanges on Twitter and US pharmacy message boards this week as hospital workers considered the tantalising possibility that the limited supply of desperately needed vaccine might be stretched to reach more people.

But it also set off a wave of confusion and debate over whether to use the extra doses, or to throw them out. At Northwell Health in New York, for example, an executive estimated that the hospital network might have thrown out enough extra vaccine to account for 15 to 20 doses while it waited for guidance from the state health department.

On Wednesday, the pharmacists got an answer. In a statement, the Food and Drug Administration said that, “given the public health emergency,” it was acceptable to use every full dose left over in each vial. The regulatory agency said it was consulting with Pfizer to determine “the best path forward” and advised health officials not to pool doses from multiple vials.

“We never want to waste – waste medication, waste vaccine,” said Anna Legreid Dopp, senior director of clinical guidelines and quality improvement at the American Society of Health-System Pharmacists. “So that would be exciting if that is an opportunity.”

The vaccine, which was developed by Pfizer and the German company BioNTech, is in extremely short supply. In a statement, Pfizer said the company was consulting with the FDA about the extra vaccine in some vials and could not “provide a recommendation on the use of the remaining amount of vaccine from each vial.” It advised staff members doing the vaccinations to consult with local institutions.

New complications

The news that hospitals may be able to vaccinate more people than expected also creates new complications. Federal officials have carefully managed the supply of vaccine, holding in reserve enough doses for each person who got the first dose to receive a booster shot three weeks later.

Ms Dopp said hospitals that squeeze extra doses will have to make sure that the person will have the second shot waiting for them. “This is where we really need nimble tracking systems and real-time information systems so that we can make these decisions in quick order,” she said.

But Ms Dopp acknowledged that it’s also a good problem to have. “These are some of the lessons that we can’t learn until vaccine is in hand,” she said. – New York Times Service