As others struggle with low vaccine supply, colleges and hospitals have a surplus problem

Conflicting, ambiguous state guidance creates confusion in vaccine rollout

The Moderna COVID-19 vaccine was unpacked in the pharmacy of Boston Medical Center.Suzanne Kreiter/Globe staff/file

Northeastern University had nearly 2,000 doses of precious COVID vaccine sitting in freezers last week after most of its front-line and emergency workers already had been immunized. So college officials informed the state that they planned to use the leftovers on other employees, including older adults and those with multiple medical conditions, who would soon be eligible under the state plan.

On Monday, the university started immunizing those workers and planned to give shots to some 730 people throughout the week. But by Tuesday, the school’s vaccination clinic had come to an abrupt halt. The state wanted the college to limit immunizations to people who were 75 or older, a relatively tiny group on a college campus, and wait until sometime in February before expanding vaccinations.

“We could have hundreds of vaccinated people walking around, but our hands are tied,” said Renata Nyul, a spokeswoman for the college. “We still believe that because we have the doses, we should move ahead. But we have been persuaded by officials in the [state] COVID command center that we should wait until next week.”

Colleges, hospitals, and other institutions are wrestling with the same problem: what to do with their surplus vaccine doses. Even as countless seniors across the state are seething that they can’t get an appointment to get vaccinated, the extra doses at Northeastern will remain untouched and in deep freeze.

The Northeastern experience offers a window into the widespread confusion and frustration over vaccine distribution in Massachusetts, and how a lack of clear information to the network of providers on how to handle excess doses has hampered the rollout.

It also underscores the daunting task of rolling out a complex system that needs to be both fair and fast, amid so much uncertainty about the supply of vaccines. Massachusetts officials have complained about recent reduced shipments from the federal government, but they’ve also struggled to use all the doses once they’re here.

The state did not respond to questions specifically regarding why Northeastern was asked to slow its vaccination program.

But in a statement, a state spokeswoman said the goal is to ensure that doses are being used wisely.

“If a site has doses on hand, they are instructed to continue vaccinating individuals as close to the current prioritization phase as possible,” said Kate Reilly, a spokeswoman for the COVID-19 command center. “The goal is to ensure that vaccine is being administered within 10 days of receipt and to minimize waste and the number of doses sitting in freezers.”

Data released Monday by the Baker administration suggested tens of thousands of doses are in freezers at hospitals and other providers. As of Tuesday, the administration said 965,975 doses were shipped to hospitals, pharmacies, and other sites in Massachusetts, but only 496,103 doses had been administered.

State figures don’t distinguish how many of the hundreds of thousands of doses in storage actually are scheduled to be used in future appointments. Further clouding the picture, hospitals are receiving shipments of second doses that are reserved for people who received their first shots about a month ago.

Massachusetts public health officials have grown concerned about a possible logjam that could hurt the state’s chances of getting more vaccine quickly from the federal government. Massachusetts ranks in the bottom half of states for the amount of vaccines it has administered per capita, according to federal data.

“The Federal Government has indicated that it will make allocation decisions based on the State’s success in vaccine administration numbers,” the state warned providers Monday on an internal state website. “Vaccine sitting idle in freezers risks the Commonwealth’s future allocations from the Federal Government.”

Up until now, hospitals have received among the most doses because the state prioritized health workers in its first phase.

Colleges, too, have received shipments of the vaccine, though the numbers vary widely. The University of Massachusetts Amherst, which is also vaccinating the region’s emergency workers, received 2,500 doses. Harvard received 600 doses. And a smaller campus such as Salem State University received 300 doses.

Officials at all three schools said they were still vaccinating employees who qualified under the first phase of the state’s rollout, just days before the second phase of the vaccine program is set to begin.

“The rollout of vaccine distribution thus far has been slower than originally anticipated,” acknowledged Giang Nguyen, executive director of Harvard University Health Services to the Harvard Gazette, a publication for university alumni and employees, last week.

Hospital officials say part of the problem is that the state’s immunization tracking system does not efficiently record how many of the thousands of doses in freezers have already been slotted for future appointments up to two weeks out, creating an incomplete picture of how the state is doing.

In fact, Dr. Andrew Karson, chief medical officer at UMass Memorial Medical Center in Worcester, said the vast majority of doses in their freezers are already accounted for.

“We have about 10,000 doses on hand now, and we have 8,500 of those scheduled for appointments over the next two weeks,” he said.

But at least some hospitals and colleges have received more vaccine doses than they could immediately use, creating a surplus that they must either find a use for or leave in storage. State guidance about how to use excess vaccine has been unclear and at times confusing, hospitals, local health departments, and colleges said.

Once a vial, which holds about 5 to 10 doses, is opened it must be administered within a few hours. Providers have been uncertain how to use those extra vaccine doses left over at the end of the day. In the absence of concrete state guidance, many hospitals have devised their own ad-hoc approach to finding people for last-minute shots.

At Salem State, doses left over because of canceled appointments have been provided to employees on campus who may be eligible in later phases of the state’s rollout. The university received a shipment of 100 vaccine doses on Tuesday, and may use some of that supply to give employees their second shot, said Elisa Castillo, associate dean of students for wellness.

At Northeastern, university officials originally thought they would need to vaccinate nursing students and included them when they ordered a shipment from the state. But many of the students were inoculated at the hospital and didn’t need to be vaccinated on campus. That left the university with doses in the freezer and officials wanted to get a head start on the next group of eligible residents.

After initially planning to use the leftover vaccines, on the advice of state officials, Northeastern put the doses back into storage so that they wouldn’t vaccinate anyone out of order.

Nada Sanders, a distinguished professor of supply chain management at Northeastern, said some of this last minute scrambling could have been prevented with earlier planning.

“Its like Whac-A-Mole now,” Sanders said. “We have this incredible talent in Massachusetts. Why don’t we have one centralized body able to oversee distribution at universities and at all the other various sites? Right now it’s fragmented, and the policies in place are fragmented.”