Missouri has wasted more than 5,000 coronavirus vaccine doses at a cost of $300,000

COLUMBIA, Mo. (KMIZ)

Missouri's wasted coronavirus vaccine from Feb. 1 through April 5 cost taxpayers more than $100,000, and Missouri providers lost out on more than $200,000 in payments from giving the shots.

ABC 17 News obtained records from Missouri's Department of Health and Senior Services that show 5,455 total doses of the coronavirus vaccine were wasted in that time period. This is in addition to the 631 doses wasted through Jan. 31.

Cost breakdown

There are two main costs that come with the vaccines: the cost per dose (the expense for each shot) and the amount paid to vaccinators for each dose administered.

The cost per dose is paid for by the federal government, which ultimately relies on taxpayers. The approximate cost for each dose varies per vaccine manufacturer based on their contracts with the U.S. government:

• Moderna - $20.50 per dose - $23,144.50 wasted in Missouri from Feb. 1 to April 5
• Pfizer - $19.50 per dose - $83,635.50 wasted in Missouri from Feb. 1 to April 5
• Johnson & Johnson - $10 per dose - $370 wasted in Missouri from Feb. 1 to April 5

Larry Jones, executive director of the Missouri Center for Public Health Excellence, which represents public health departments in the state, said even though it is a small amount, wasting money is still wasting money.

"And it's our dollars because it's tax dollars that are being wasted," Jones said. "Anything that we can do individually to help providers, we need to do."

Since the Biden administration pays $40 for each dose administered through Medicaid and Medicare, that is the approximate cost Missouri providers lose when a vaccine is marked as waste. However, not all vaccinators are collecting that money.

"They're trying to do it so fast, trying to get as many as possible, that they've not taken the time to collect all insurance information, Medicare/Medicaid information, in order to be able to bill a third party for the vaccine," Jones said.

When a dose is wasted, though, it eliminates even the possibility of payment for providers.

"You can't bill for something you don't do," Jones said.

Shipping issue causes largest waste

Bothwell Regional Health Center lost out on about $46,800 in the state's largest instance of reported waste, when 1,170 Pfizer doses were spoiled through no fault of the medical center.

Missouri Department of Health and Senior Service spokeswoman Lisa Cox said in an email the issue was caused by the vaccine being exposed to temperatures outside the required temperature range during shipment.

"Bothwell, for example, had to report a large amount of wastage due to temperature excursion during transport, but they were not responsible for the handling during this transport. It was then in their possession, so they reported the necessary wastage. . . We’ve also had issues when deliveries were made directly by vaccine manufacturers where the vaccine temperature was not maintained. These are extremely rare circumstances compared to the millions of doses properly stored, transported and administered."

Lisa Cox, DHSS Communications Director

The department did not respond to requests for an interview. Bothwell Regional Medical Center declined to do an interview for this piece, but a spokesperson said in an email that all patients who were scheduled to receive a coronavirus vaccine from this shipment were able to.

Jones said it is rare to see issues with shipping, but it can happen because of circumstances out of a driver's control.

"Especially during the winter, when we had the snowstorms and the ice storms and those types of things, there were some delivery problems ..." Jones said. "If a truck would happen to get stopped someplace for some reason, you might lose the capabilities of keeping the vaccine at the right (temperature) area."

View each provider's reported waste from Feb. 1 through April 5 in the map below.

The coronavirus vaccine cannot be returned to the manufacturer, which is different from other vaccine programs, officials have said. This means Missouri doses that have been wasted are not reallocated to the state, regardless of the situation.

Other states got luckier with successful deliveries. For example, Kansas records show not a single instance of similar-scale vaccine waste due to transport issues. Its largest reported waste was 570 doses caused by broken vials.

Most common reason for waste: 'Not administered'

Out of the more than 600 records of waste, more than half cited "open vial but all doses not administered" or "vaccine drawn into syringe but not administered" as the reason for waste.

In Mid-Missouri, the Randolph County Health Department reported the second-highest number of wasted doses at a single provider: 133. While one wasted dose was blamed on a broken vial, all other doses were from already-opened vials that ended up not being used. At least 24 of these were due to Missourians not showing for their second vaccination appointment.

The Randolph County Health Department did not respond to multiple email and phone requests for comment.

Missouri's data also excludes vaccines wasted through federal providers, such as the Federal Retail Pharmacy Program. ABC 17 News has requested this data, but has not yet received a response.

Though wasted doses remain few compared the total number of doses administered in Missouri, it's more than doubled from the previous time frame.

About .058% of doses went to waste through Jan. 31. With more than 3.4 million doses having been administered as of Sunday morning, the rate from Feb. 1 to present is about .2%.

Is there a solution?

According to Jones, yes. With demand for the coronavirus vaccine decreasing in Mid-Missouri, single-dose vials could help.

Right now, all three vaccines approved for emergency use come in multi-dose vials. Pfizer vials contain up to six doses, Moderna vials have 11 and Johnson & Johnson vials have five.

While these multi-dose vials are helpful for mass vaccination, they can be a burden when doing individual vaccinations, which is the direction in which the state is likely headed as demand slows.

"If you have a vial that has 10 doses of vaccine in it, or six in the case of Pfizer, it means you need to have the ability to get to that many people at the same time," Jones said. "That can be difficult when you're making home visits, when you're going into a home that only has three to five people that are living there."