Officials at Mazzoni Center are taking issue with a new directive from the city of Philadelphia and the Centers for Disease Control and Prevention that prevents service providers from inoculating people with extra doses of the COVID-19 vaccine extracted from vials.
Mazzoni is a comprehensive health-care agency located in Center City with a large LGBT clientele. So far, it’s administered just over 1,000 COVID vaccines to clients. In the past, staffers would pull about fifteen extra doses from vials each week and administer them to clients. But on March 12, the city emailed a directive to the agency stating: “Per the Centers for Disease Control and Prevention, any doses beyond the approved [emergency use authorization] should not be pulled for administration.”
The directive went on to state that only 10 doses per vial may be pulled from the Moderna vaccine vial, only six doses from the Pfizer vaccine vial and only five doses from the Johnson & Johnson vaccine vial. Mazzoni uses Moderna vaccine vials.
Critics of the policy say hundreds of doses are being unnecessarily discarded in Philadelphia on a daily basis rather than going into the arms of eligible vaccine recipients.
“Typically we get 11, sometimes 12 doses from each [Moderna] vial,” said Larry Benjamin, a Mazzoni spokesperson, in an email. “They [CDC and city] are saying anything over the 10 doses [from a Moderna vial] must be discarded. As a result, we had to waste five doses yesterday. For the first time after administering more than 1,000 doses, we had vaccine that went into the trash instead of someone’s arm. We deeply disagree with this order for obvious reasons. But we are bound by their orders or we risk being cut off from obtaining vaccine — which we know is desperately needed.”
Jasmine Santana, medical assistant supervisor at Mazzoni, also expressed disagreement with the new policy. “It’s very sad,” Santana told PGN. “It really did bother us all deeply. We had a very tried and true system. We figured it out. And it deeply disturbed us to discard those additional doses. We’ve never thrown out any doses before this directive.”
Santana said Mazzoni pulled about 120 extra doses since January, prior to the new policy. “That’s 60 people [that got vaccinated],” she said. “It’s been pretty tough to get a [vaccine] appointment in Philadelphia. To be able to help out and vaccinate 60 extra people is an accomplishment for us.”
James Garrow, a spokesperson for the Philadelphia Health Department, explained the new policy. “The CDC has reiterated that the emergency use authorization that COVID vaccines are being administered under allows only a certain number of doses per vial,” Garrow said, in an email. “The rationale of their reiterating that is because we need to ensure that people can get second doses in the correct time frame. If we pull an extra dose from 10 Moderna vials at a clinic, then we would need to bring an additional vial to the second dose clinic, and we cannot order those extras. Pulling extra doses leaves people who need their second dose scrambling to find a second dose.”
Garrow said the policy isn’t “optional,” thus city health officials aren’t considering revising it. Garrow also said that wastage concerns expressed by Mazzoni “should be directed at Mazzoni’s contact in the [city’s] Immunization Program. They can explain the process, the new policy, and can work with them to develop processes to help minimize any wastage.”
In a related matter, Benjamin expressed concern with a new requirement that COVID vaccines be transported in a cooler when inoculations are administered offsite. He said a cooler is required even if the site is within walking distance, for example from Mazzoni Center at 13th and Bainbridge streets to the John C Anderson Apartments at 13th and Spruce streets. “This makes no sense,” Benjamin said. “Vaccine is good for 10 hours and we don’t have any events that are more than 8 hours tops.”
Benjamin noted that a cooler costs approximately $700. “[That] may not seem like a lot of money to the city,” Benjamin added. “But for us and other nonprofits it’s an unexpected expense that could potentially pull funding from other needed programming,”
Santana echoed Benjamin’s sentiments. “I would think the city would be able to help,” she said. “We are a year in this epidemic and the supply never seems to quite meet the demand — whether that be syringes or coolers or anything else we might need to effectively vaccinate the community.”
Regarding the new requirement for a cooler, Garrow said: “There are strict guidelines from the manufacturers about transporting, storing, and preparing vaccine through the cold chain. If the cold chain is broken — at all — the vaccine doses can spoil and they would all need to be thrown away. Some of the guidelines are as strict as requiring that the freezers with vaccines in them not being open for more than two minutes.”