Coronavirus vaccines have a shelf life of six months, after which they must be thrown away by medical providers.
No one who is trained to administer vaccines can bear to throw them away, and San Diego County medical providers thought they had come up with the perfect solution: Ship some of those expiring doses to Tijuana or other parts of Baja California, where they might find a healthy arm before expiration in a cold freezer.
But that idea, Dr. Eric McDonald, chief medical officer for the county health department, said in a statement Wednesday night, was rejected by the federal government, which has the final say on any such initiative.
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“I contacted the White House Vaccine Task Force and they said it was not possible,” the McDonald statement said.
When asked for an explanation Wednesday, neither the White House nor the Federal Health and Human Services Agency had responded to explain the situation as of Friday afternoon. The Washington Post, in an article on the matter published Friday morning, quoted “White House officials” as saying that vaccines “are the property of the federal government, not the cities or states in which they are distributed.” which means that “the federal government is responsible for its use, and donation efforts must be carried out from Washington.”
This explanation proved somewhat infuriating to San Diego healthcare providers.
Brett McClain, chief operating officer for Sharp HealthCare, the region’s largest healthcare system, said it was not so much about large stocks of vaccines nearing expiration as about a collective desire for a comprehensive plan to when expiration dates are approaching.
“It was more of a conversation around ‘what is our ongoing process for this going to be?” McClain said, adding that rumors that Sharp destroyed a large quantity of Johnson & Johnson vaccines destined for Mexico are not true.
The Washington Post article refers to 10,000 doses that were collected throughout Southern California and blocked from being shipped to Mexicali, although the exact sources are not specified.
According to the California Department of Public Health, vaccine supply has so far been roughly equal to demand, and San Diego County providers are wasting less than many places in the state and nation.
About .6 percent of the nearly 5.2 million doses delivered to the region have been wasted, compared to 1.1 percent of the 58 million doses shipped statewide, according to the CDPH. And about 4.7 percent of the more than 493 million doses of coronavirus vaccines delivered across the United States have been wasted, said Katherina Grusich, a spokeswoman for the Centers for Disease Control and Prevention.
“This rate is still low,” Grusich said in a statement. “Sometimes the waste comes as part of the process to ensure that anyone who wants a vaccine can get it.”
He notes that the wastage rate is typically 5 to 15 percent for other vaccines administered in multi-dose vials. Along similar lines, a 2019 report from the World Health Organization found that vaccination campaigns typically waste 10-15 percent of doses.
Still, there is a desire to share on both sides of the border when doses are about to expire.
San Diego, according to McClain and others, has a close relationship with northern Mexico, especially Baja California and its 3.7 million residents. Thousands of people cross every day on work visas and green cards, not to mention the 1 million US citizens who choose to live south of the border, but often flock north for everything from shopping to healthcare.
“There are people who come and go across the border every day for work and for other reasons, and they are members of our community,” McClain said. “We have a lot to do with trying to protect that geographic circle as much as possible; it’s the right thing to do, but it’s also important to do it as we get closer and closer to what is going to be a normal level of vaccination here in San Diego. “
Having traveled to Tijuana hospitals flooded with COVID in 2020 to help his cross-border colleagues, Dr. Jess Mandel, director of pulmonary critical care at UC San Diego Health, said the current policy makes no sense.
“The idea that it’s better to throw away the doses than to help the people across the border who need and want them, it seems like we should keep thinking creatively about ways to deal with that,” he said.
While he said he understands the federal government’s desire to find a universal solution to the problem of expiring vaccines, all policies should be flexible.
“I don’t know what Detroit and Chicagoans should do if their vaccines are about to expire, but it is clear what we can do in San Diego by virtue of our geography,” Mandel said.
Liability issues, he added, appear to be surmountable.
“It seems like I sign five disclaimers a week,” Mandel said. “I feel like there must be a way.”
Ambassador Carlos González Gutiérrez, the consul general of Mexico in San Diego, said that both sides of the border are fully aware of the need to collaborate.
“At the risk of stating the obvious, public health authorities in each country know that they have little or no control over public policies that apply across the border,” he said. “But they also know that, at the local level, we are talking about a single community. That is why state and local authorities are always looking for pragmatic, creative and innovative approaches to common problems ”.
At the moment, however, the need is greater throughout Mexico than in Baja California: About 80 percent of Baja California residents are vaccinated, most with single-dose vaccines from Johnson and Johnson. Nationally, however, Mexico’s vaccination rate is around 40 percent.
Not that the United States is generally stingy in its efforts to send doses to other nations. As of October 21, the US State Department had a list of more than 200 million doses donated to more than 100 countries around the world. The total for Mexico, according to the official website of the State Department, already exceeds 7.5 million. The U.S. Embassy in Mexico puts the total at 10.9 million due to the arrival of another 3.4 million doses of AstraZeneca that arrived more recently.
Many of those who spoke about the cross-border vaccine situation noted that due to the large number of comings and goings of US expatriates and workers living in Mexico, the region will not really have the virus under control until both sides of the border are vaccinated. But getting there already includes some cross-border aid. The University of California, San Diego, conducted a vaccination program during the summer in which about 26,000 boys and girls were vaccinated.
Not that the United States is generally stingy in its efforts to send doses to other nations. As of October 21, the US State Department had a list of more than 200 million doses donated to more than 100 countries around the world. The total for Mexico, according to the official website of the State Department, already exceeds 7.5 million. The U.S. Embassy in Mexico puts the total at 10.9 million due to the arrival of another 3.4 million doses of AstraZeneca that arrived more recently.
Many who spoke about the cross-border vaccine situation noted that due to the large number of comings and goings of US expatriates and workers living in Mexico, the region will not really have the virus under control until both sides of the border are vaccinated.
But getting there already includes some cross-border aid. The University of California, San Diego, conducted a vaccination program during the summer in which some 26,000 maquiladora workers were vaccinated at the San Ysidro port of entry.
UCSD infectious disease specialist Dr. Shira Abeles said Friday that the effort, which technically remained on U.S. soil, was able to run smoothly in late July and early August, with workers being taken to the border by bus. , monitored for side effects, and then sent to their homes and jobs in Mexico.
Early in the vaccination effort, Abeles noted, everyone was intensely focused on making sure that the leftover thawed doses went to the arms and few were wasted. That need to use every last drop, he said, has not diminished among those pushing syringe plungers, even as the supply of vaccines has increased and some have refused to receive their injections.
“We tried very hard not to waste a single dose in the beginning, and it’s still a shame when we have to waste even five doses,” Abeles said.
And the need for countries to share beyond their borders is greater than San Diego and Tijuana.
The whole country is interested in seeing as many doses received outside of the United States as possible.
Matt Daugherty, a molecular biologist and UC San Diego assistant professor who studies viral evolution, noted that one of the biggest factors determining whether the coronavirus will mutate and create additional variants is the number of times it infects human hosts. Every time the virus replicates inside a human cell, there is a very small chance that the genetic code is not copied correctly, resulting in new versions that can, only by chance, end up with a new feature that helps them. to spread more easily.
The Delta variant that has caused many cases in recent months came from India, where vaccination rates were relatively low and the number of cases was high. The large increases in cases in Brazil and South Africa have also generated variations for similar reasons.
Therefore, the United States has a great interest in reducing the number of infections that occur worldwide.
“If it’s wreaking havoc in some places, that means diversity is still building up and it could easily return to areas where it is currently controlled,” Daugherty said. “Everyone has to understand that control must be done globally, not just locally, to prevent the next variant of the Delta from appearing.”
UT journalist Jonathan Wosen contributed to this report.
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