Arizona Department of Health Services (DHS) spokesperson Steve Elliott said the expired vaccines were due to an "unusual" number of no-show appointments between midnight and dawn that night. He said that employees at the state-run site were unable to call in additional patients in the middle of the night.
"ADHS considers it unacceptable if even one usable dose of vaccine isn’t used as intended," Elliott said in an email. "Staff and partners immediately used this situation as a case study to improve communication and procedures between clinical workers checking in patients and administering vaccine in the parking lot and the pharmacy staff thawing and drawing doses within the stadium."
Elliott said that going forward, the amount of doses thawed and prepared by the site's pharmacy will be adjusted based on what frontline staff are seeing.
The 228 doses are a small portion of the number administered by the site each week, but stand out in the vaccine wastage reports submitted to DHS and obtained by Phoenix New Times from the agency. The next largest losses were reported in January, when the La Paz County Health Department had to discard 100 doses after the first shipment it received arrived spoiled, and in late December, when Northern Cochise Community Hospital had to discard 70 doses that were improperly stored. No other report lists more than 30 vaccines discarded at a time, and most of the 33 total reports list only a handful of doses lost, for a total of 626 discarded doses so far statewide.
The reports appear to not cover all vaccination sites. There are no reports from Maricopa County sites, which discarded 553 vaccines in the first month of the vaccination campaign. A county spokesperson did not immediately respond to an inquiry about the absence Monday morning.
State officials had trumpeted State Farm Stadium's 24-hour schedule as a way to avoid waste, even pointing out that extra doses from other sites had been brought there instead of being thrown away. When the number of discarded vaccines at county sites was reported in early February, Governor Doug Ducey claimed that no doses had been, or would be, wasted at state-run sites.
The #COVID19 vaccine is a precious and limited resource — that any doses would be wasted is shocking and unacceptable. This has not and will not happen at any state-run sites, and local leaders must prevent it from ever happening again at any county-run site. https://t.co/MzLZZzg645— Doug Ducey (@dougducey) February 2, 2021
Dr. Doug Campos-Outcalt, a senior lecturer at the University of Arizona's public health school and a former medical director of the Maricopa County Department of Public Health, told New Times then that he thought that was unrealistic. But on Monday, Campos-Outcalt said he was "a little perplexed" about how vaccines could have expired at the 24-hour site.
"Somebody appears to have miscalculated," he said.
It's easy to second-guess, Campos-Outcalt said, but the supply chain is complicated, with multiple factors that have to be considered, such as how long Pfizer vaccines take to thaw, and how much time there is after thawing for vaccines to be used.
"How easy is to get people to come in off a waiting list between midnight and 8 a.m.? I imagine pretty tough," he said.
ADHS has previously said they were seeing more canceled appointments as eligible Arizonans were able to snag earlier slots. The agency now only books appointments one week in advance, opening up times for the following week at 11 a.m. on Fridays. Last week, nearly 40,000 appointments for State Farm Stadium were snapped up within an hour.
The Monday after the vaccine wastage, the state expanded eligibility to all adult Arizonans. Elliott said this was not a result of the no-shows, but acknowledged that it would help prevent a repeat of March 18. In the meantime, State Farm Stadium appears to be dealing with the opposite issue: delays caused by too many people showing up slowed the site last week.
Appointments are required at state #COVID19 vaccination sites. And if you have an appointment, you need to show up close to your appointed time. State Farm Stadium is seeing delays due to both of these issues.— AZ Dept of Health (@AZDHS) March 28, 2021