NEW YORK (NYTIMES) - US state health officials are growing increasingly concerned about whether doses of the Johnson & Johnson coronavirus vaccine may expire this month, warning they could go to waste if they go unused in the coming weeks or are not sent elsewhere.
Governor Mike DeWine of Ohio has pleaded with health providers in his state to use around 200,000 doses of the vaccine that he said on Monday (June 7) were set to expire on June 23. The state's health department directed providers to adopt a "first-in, first-out" process for the shot to ensure doses with earlier expiration dates were used first.
Arkansas' state epidemiologist said last week that as many as 60,000 doses of Johnson & Johnson may not be used there in time.
Dr Marcus Plescia, who represents state health agencies as the chief medical officer for the Association of State and Territorial Health Officials, said he believed the expiration risk for Johnson & Johnson was a problem in every state. Over 10 million doses of the vaccine have been delivered to states but not administered, according to data collected by the Centres for Disease Control and Prevention.
Mr Andy Slavitt, a White House pandemic adviser, said on Tuesday at a news conference that the federal government was encouraging governors to consult with the Food and Drug Administration on storage procedures as the agency examines how to possibly extend the shelf life of the vaccine. He said the agency was "looking at opportunities for continued storage".
An FDA spokeswoman on Tuesday referred questions about the vaccine's shelf life to Johnson & Johnson.
"We continue to work with the US government and health authorities to support the use of our vaccine, which continues to play an important role, including among those who wish to be fully vaccinated with one shot," the company said in a statement. "We also continue to conduct stability testing with the goal of extending the amount of time our Covid-19 vaccine can be stored before expiry."
The single-dose Johnson & Johnson vaccine can be stored at normal refrigeration temperatures for three months, conditions that have allowed states to reach more isolated communities that may find it more difficult to manage the two-dose vaccines made by Pfizer-BioNTech and Moderna, which have stricter storage requirements. Pfizer's vaccine expires six months from its manufacture date.
Concerns among state health officials about the Johnson & Johnson doses have dovetailed with a significant drop in vaccination rates across the nation.
As of Monday, providers were administering about 1.13 million doses per day on average, around a 67 per cent decrease from the peak of 3.38 million reported April 13. About 64 per cent of US adults have received at least one shot, according to federal data.
Ohio officials said this week that they were not legally allowed to send the doses to other states or countries. Once vaccines are shipped out to states, federal regulations have prohibited recalling them even if they are not needed domestically.
As the United States struggles to use up its supply of vaccines, other countries continue to plead with the US and other wealthier nations to share doses. More than 2.18 billion vaccine doses have been administered worldwide, equal to 28 doses for every 100 people, with some countries yet to report a single dose, according to Our World in Data at the University of Oxford. There are 24 countries that use the Johnson & Johnson vaccine.
Dr Tedros Adhanom Ghebreyesus, the director-general of the WHO, bemoaned at a news conference on Monday what he called a "two-track pandemic", with wealthy countries using much of the world's vaccine supply.
"The inequitable distribution of vaccines has allowed the virus to continue spreading, increasing the chances of a variant emerging that renders vaccines less effective," Dr Tedros said, adding that "the biggest barrier to ending the pandemic remains sharing: of doses, of resources, of technology".
At the White House news conference, Mr Slavitt said it was unrealistic to expect that the US could avoid wasting some vaccine doses, adding that any expired Johnson & Johnson doses would not significantly affect the administration's efforts to help vaccinate other countries.
"There is a very, very small fraction of doses that have been sent out to states that will ultimately not be used," he said. "These will be fractional amounts and really will not have any significant bearing on our ability to commit to distribute vaccines globally."
The Biden administration has pledged to send 80 million doses abroad by the end of the month, the first major tranche in what White House officials have said would be a sustained campaign to ship vaccines to needy areas of the world. Many of those doses were produced by AstraZeneca and are currently tied up in an FDA safety review.
Last week, the administration announced it would distribute an initial 25 million doses this month across a "wide range of countries" in Latin America and the Caribbean, South and South-east Asia, and Africa, as well as the Palestinian territories, war-ravaged Gaza and the West Bank. Three-quarters of the initial batch will be given to the international vaccine effort known as Covax.