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C2 THE BULLETIN • SUNDAY, MAY 9, 2021 COVID-19 | Vaccine rollout CVS, Walgreens show the bulk of wasted doses BY JOSHUA EATON AND RACHANA PRADHAN Kaiser Health News Two national pharmacy chains that the federal gov- ernment entrusted to inocu- late people against COVID-19 account for the lion’s share of wasted vaccine doses, accord- ing to government data ob- tained by Kaiser Health News. The Centers for Disease Control and Prevention re- corded 182,874 wasted doses as of late March, three months into the country’s effort to vac- cinate the masses against the coronavirus. Of those, CVS was responsible for nearly half, and Walgreens for 21%, or nearly 128,500 wasted shots combined. CDC data suggests that the companies have wasted more doses than states, U.S. territo- ries and federal agencies com- bined. Pfizer’s vaccine, which in December was the first to be deployed and initially required storage at ultracold tempera- tures, represented nearly 60% of tossed doses. It’s not completely clear from the CDC data why the two chains wasted so much more vaccine than states and federal agencies. Some critics have pointed to poor planning early in the rollout, when the Trump administration leaned heavily on CVS and Walgreens to vac- cinate residents and staff mem- bers of long-term care facilities. In response to questions, CVS said “nearly all” of its reported vaccine waste occurred during that effort. Walgreens did not specify how many wasted doses were from the long-term care program. One thing is clear: Months into the nation’s vaccination drive, the CDC has a limited view of how much vaccine is going to waste, where it’s wasted and who is wasting it, potentially complicating efforts to direct doses to where they are needed most. Public health experts say having a good han- Stock Continued from C1 Alas, things rarely go that well with a trade. And when a stock is getting clobbered, you fail to cut your losses , clinging to hope of a recovery that can prove elusive. Tip No. 3: Sometimes the best decision is to do nothing It seems these days that the term FOMO , or fear of miss- ing out , gets bandied about a lot. With all the news about riches to be had in the mar- kets — buying the likes of the GameStop — it seems like we should be harvesting our share of the goods by getting in early on the next big thing. But in the quest to do so, we sometimes feel a temptation to make purchases that aren’t really well thought out. Often, this results in disappointing outcomes. Unless you are certain that you have an investment that you understand and makes sense, it’s better to do noth- ing. Nobody lost a penny on money they didn’t invest. dle on waste is crucial for de- tecting problems that could de- rail progress and risk lives. The Pfizer-BioNTech and Moderna vaccines, which come in multidose vials, are fragile and have limited shelf lives. Overall, waste has been minuscule: As of March 30, the U.S. had delivered roughly 189.5 million vaccine doses and administered 147.6 mil- lion, including 7.7 million in long-term care facilities, ac- cording to the CDC. Among other things, tracking wasted doses helps to identify bottlenecks where distribution adjustments might be needed, said Dr. Bruce Y. Lee, a profes- sor of health policy and man- agement at the City University of New York. Because the fed- eral government is footing the bill for the country’s doses, any waste amounts to “basically throwing (taxpayer) money down the chute,” he said. CVS, Walgreens and other retailers don’t pay for the vaccine. The government provides it. And under the Medicare program, it pays providers roughly $40 for each dose administered. Particularly early on, offi- cials didn’t adequately assess where there would be demand and set up sites in response, Lee said — something that’s es- pecially important when trying to jab as many people as possi- ble as quickly as possible. “If you think of any business, they’re going to determine where the customers are first,” he said. “It’s not just a matter of loading up vaccine and going to a place.” Kaiser Health News’ sur- vey of vaccine waste is based on public records requests to the CDC and all 50 states, five major cities, Puerto Rico and Washington, D.C. Combined, the records document more than 200,000 wasted doses. However, the data has clear shortcomings. Data from 15 states, the District of Columbia and multiple U.S. territories are the influence of emotions on trading is to establish disci- plines — like sell targets — that create a process in place of trading on whimsy. CVS and Walgreens didn’t have a clue when it came to interacting with nursing homes. Missed opportunities for vaccination in long-term care invariably result in deaths.” — Dr. Michael Wasserman not included in the CDC’s re- cords. And, in general, waste re- porting has been inconsistent. In addition to the CDC, 33 states and D.C. provided at least some data to Kaiser Health News in response to those records requests. They reported at least 18,675 ad- ditional doses that have been wasted across 10 jurisdictions not represented in the CDC figures. They include 9,229 doses wasted in Texas as of March 26 and 2,384 in New Hampshire as of March 10. An additional eight states told Kaiser Health News of more wasted doses than they reported to the CDC. But no city or state comes close to the waste reported by CVS and Walgreens, whose long-term care vaccination drive was criticized by some officials as slow and ineffective. Among nursing home staffers, a median of 37.5% reported they got a shot in the first month, according to a Febru- ary CDC study. “To me, this ultimately cor- relates with just poor plan- ning,” said Dr. Michael Wasser- man, immediate past president of the California Association of Long Term Care Medicine and a critic of the corporate effort. Wasserman said the compa- nies’ approach was too restric- tive, and their unfamiliarity with long-term facilities’ needs harmed the effort. “CVS and Walgreens didn’t have a clue when it came to in- teracting with nursing homes,” he said. “Missed opportuni- ties for vaccination in long- term care invariably result in deaths.” A CVS spokesperson, Michael DeAngelis, in an email blamed wasted doses on “issues with transportation restrictions, limitations on re- directing unused doses, and other factors.” “Despite the inherent chal- lenges, our teams were able to limit waste to approximately one dose per onsite vaccination clinic,” he added. Walgreens said its wastage amounted to less than 0.5% of vaccines the company ad- ministered through March 29, which totaled 3 million shots in long-term care facilities and 5.2 million more through the federal government’s retail pharmacy partnership. “Our goal has always been ensuring every dose of vac- cine is used,” company spokes- person Kris Lathan said in an email. Before scheduled clinics, she said, Walgreens would base doses it would need on regis- trations, “which minimized excess and reduced overesti- mations.” Vaccine waste could increase in the coming weeks as offi- cials shift tactics to inoculate harder- to-reach populations, public health experts say. “I think we are getting to a place where, to continue to be successful with vaccination, we’re going to have to tolerate some waste,” said Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials. People unwilling to travel to a mass-vaccination site might go to a primary care physician or smaller rural pharmacy that might not be able to use every dose in an open vial, he said. The reasons states gave for waste varied, from broken vi- als and syringes to provider storage errors, to leftover doses from open vials that couldn’t be used. The largest waste incidents, in which hundreds of doses were lost at a time, tended to be due to freezer malfunctions or workers leaving doses at room temperature too long. But state records also regis- ter the little things that can go wrong. On Dec. 16, the public health department in Gunnison County, Colorado, lost a single dose of the Pfizer vaccine when someone bumped into a table and a vial spilled. On Jan. 5, the Tri-County Health Department in Westminster, Colorado, re- ported that it wasted a Mod- erna dose because a hypoder- mic needle bent. Remi Graber is a registered nurse who has vaccinated peo- ple at mass sites and commu- nity health clinics in Rhode Island. They said it’s not un- common for a vial to have one too many or one too few doses, which can lead to a dose being counted as wasted. There are also sometimes syringe prob- lems that result in waste. But Graber said the biggest problem is people not showing up. Once a vial is punctured, Pfizer’s vaccine must be used within six hours. On April 1, Moderna announced that an opened vaccine vial was good for 12 hours — double what it had been previously. “What could happen is you get people who just decide, ‘You know what? I don’t need my vaccine today. I’m not go- ing to show up,’” they said. “Well, now we’re scrambling to find somebody to take the vac- cine because we don’t want to waste it. William Valentine, CFA, is the Co- Chief Investment Officer of ASI Wealth Management of Bend. He and his wife, Jessica, have lived in Bend since 2000, where they raised their four sons. Ways you can support Thelma’s Place: • Vehicle donations • Cash donations • Sponsorships • Volunteer CHILD CARE AN INTERGENERATIONAL PROGRAM Your support makes a difference! Redmond: 541-548-3049 Day Respite and Support Groups www.thelmasplace.org Hope Starts Here Donate Today Child Abuse Prevention mtstar.org | 541-322-6828 Tip No. 4: Never trade when you’re feeling emotional If you’ve read this column over time, you’ll recognize a theme that I’ve hopefully cultivated: Emotions are the enemy of the investor. That’s equally true of traders as well. 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