As Oregon struggles to get more people vaccinated, it is stockpiling vaccines.
The state now has enough on hand to last about 80 days, if the current vaccination rate holds.
In one of its latest -- and biggest -- recent deliveries, the Oregon Health Authority received 60,000 doses of Johnson & Johnson vaccine on Sunday. Compared with the Pfizer and Moderna vaccines that require two doses, this one only needs one for full inoculation. And it can be stored in a refrigerator. The Pfizer and Moderna vaccines must be stored at freezing or ultra cold temperatures.
But there’s a big hitch with the Johnson & Johnson doses: They are due to expire by the end of the month, and it’s highly unlikely they will be used by then.
“We could end up having a lot of them expire before we can get them used," Patrick Allen, director of the Oregon Health Authority, told a legislative committee on Monday.
Nevertheless, the state jumped on the chance to bring more into Oregon when Texas said it had too much.
“They didn’t think they were going to get any of those doses into arms,” Dave Baden, the Oregon Health Authority’s chief financial officer, told The Lund Report. “We knew we would get some (administered).”
Oregon is pushing to get adults vaccinated even as the number of people willing to get a shot dwindles. Gov. Kate Brown said that when 70% of those at least 18 years old have one shot of any vaccine, that she will lift mask and social distancing requirements, effectively reopening the state. She set June 21 as a target.
Oregon has accumulated a massive stockpile to meet that goal.
About 3.7 million Oregonians are at least 12 years old and eligible to be vaccinated. So far, the state has fully inoculated nearly 2 million, and about 300,000 have had a single shot and need a second dose. When all of those are fully inoculated, there will be 1.4 million people remaining in Oregon eligible for vaccination.
The state has about 1.2 million doses on hand -- of all three types. That’s enough to fully inoculate about 500,000 people, according to an analysis by The Lund Report.
At the current seven-day average of 15,000 shots a day, administrators should have enough doses for about 80 days.
Demand for shots is plunging, however, meaning the supply could last much longer. For much of April and May, 30,000 to 40,000 people a day were getting shots. Now, on some days, the number has dropped below 10,000.
The vaccine stockpile is so big that the state has sharply cut its weekly orders from the federal government.
The vaccine glut means providers have the freedom to throw more of it out if they can’t use it. Now, if only a couple of patients show up for shots, a provider can extract vaccine from a multi-dose vial -- Moderna has started to ship 15-dose vials -- and not feel pressured to find enough patients for every potential syringe before it expires.
“We really now have the priority being (to) get someone vaccinated," Allen told lawmakers. "If you're going to open a vial and there's someone there to be vaccinated and you're not sure you're going to be able to use the rest of the vial, that's OK. Go ahead and get that person vaccinated, because we have plenty of vaccine."
State Lags In Administering Shots
Still, other states are using their supplies more quickly than Oregon.
According to a New York Times tally, Oregon is 40th in the nation in administering vaccines on hand. It has used 77% of the amount it has been supplied -- the same as Idaho, Delaware, Maryland, Arizona and Texas. With the exception of Alaska, which has administered 76% of its supplies, all of the other states with lower percentages are in the south. Alabama is last at 67%.
Washington state, by contrast, has used up 87% of the doses it has received, making it the eighth best state for getting shots into arms, according to the tally. California is ranked 24th, administering 83% of its doses.
The strategies of other West Coast states -- and even those in the South where vaccination rates are relatively low -- are unclear. Oregon, however, has put a priority on having enough inventory on hand to meet the demand of everyone who wants a shot.
State officials have ordered more than needed to ensure they had “residual supply” around the state, the Baden, of the health authority, told The Lund Report.
Johnson & Johnson shots are good for vaccinating hard to reach people who might not return for a second shot, but the state also has supplied that vaccine to mass vaccination clinics at the Oregon Convention Center and Oregon Health & Science University’s sites at a Portland International Airport parking lot and at Hillsboro Stadium.
Although they are closing those sites in just over a week and are now focused on administering second doses, officials there wanted to have some Johnson & Johnson vaccine on hand, Baden said.
“They wanted the opportunity to be able to give first doses and make appointments for people to walk in,” Baden said. “Johnson & Johnson is what makes sense in that circumstance.”
The convention center announced on Thursday that it is giving away 1,500 $100 gift cards to Fred Meyer and Safeway to people who get a Johnson & Johnson shot before the site closes. OHSU is offering a similar incentive at the airport and in Hillsboro.
Johnson & Johnson doses also have been delivered to every county in Oregon, and state officials also have made the Pfizer vaccine widely available.
“We’ve been able to get Pfizer out very broadly across the state even into more rural counties that did not have large deep freeze or storage,” Baden said.
The vaccine is stored in a scattering of hubs that are equipped with ultra cold storage. The hubs allow officials to ship small quantities to providers in rural areas or to those who might not need many doses. In May, the U.S. Food and Drug Administration said that the Pfizer vaccine can be safely stored in a refrigerator for a month.
“I’m not aware of any other states that are doing that model,” Baden said. “It’s pretty innovative to be able to assure that Pfizer is available in more places across the state.”
New Attitude Towards Waste
When the vaccine campaign began in December, every dose was precious. Now state officials are not fretting about waste, Allen told the COVID-19 subcommittee on Monday.
In the early months of the vaccine drive, demand was greater than the supply and officials went to great lengths to use all doses, he said.
“Any wasted dose was a dose that could be given to somebody somewhere that day and so dropping a vial was a big deal," Allen said.
But now saving every dose is not a priority.
This shift in attitude has led to an acceleration of tossed vials. Last month the number of doses wasted since December more than doubled to over 9,000 towards the end of the month. This Tuesday the state reported more than 20,300 wasted doses since the start of the vaccination drive. Most of them were Moderna -- over 13,300. Pfizer accounted for about 4,300 doses and nearly 2,700 Johnson & Johnson shots were tossed.
Johnson & Johnson spoilage is certain to grow, and not only in Oregon. There are hundreds of thousands of doses nationwide that will soon expire.
That’s prompted the federal government to launch a study of the Johnson & Johnson vaccines to determine how long they can remain viable.
In the meantime, Oregon has curtailed orders from the federal government.
A lot of people don’t want a shot, state officials acknowledge.
“The demand generally is slow across the state,” Baden said.
For weeks the federal government has offered about 230,000 doses a week to Oregon. The state accepted them, and pushed them out to provider sites and hubs. Now it’s stopped accepting full deliveries and instead has asked administrators to order what they need.
“We have not ordered our full amount for the last three weeks,” Baden said.
On its weekly delivery day on Tuesday, Oregon received only about 4,800 doses of Pfizer and Moderna vaccine, state data show.
Cases, Hospitalizations Drop
As more people have become vaccinated, COVID-19 infections have fallen. Over the past week, the health authority has reported about 280 new cases a day. Hospitalizations have slowed to the point they were at last July through October, before demand for beds went up. Unlike early in the pandemic, those suffering severe illness now tend to be younger.
These shifts have coincided with the drop in vaccine demand.
Right now, nearly 64% of Oregonians aged 18 and older have had one shot, according to the Centers for Disease Control and Prevention.
Oregon ranks in the middle of the pack nationwide in terms of the percentage of those vaccinated in the 18 to 64 year old group and the 65-plus category, but it’s 11th nationwide in the vaccination of children 12 to 17, a New York Times tracker shows.
“Our rate of vaccination of 12 to 15 olds has been relatively robust compared to most other states,” Baden said. “Benton County was able to vaccinate nearly 50% of 12 to 15 year olds in one to two weeks. That is a sign of hope.”
But officials are going to have to raise the rates in Eastern Oregon, which has the lowest partial and full vaccination rates in the state, from 27% of residents fully inoculated in Lake County and Umatilla counties to 25% in Malheur. Baden indicated that increasing the rate may be a matter of administering a few vaccinations here and a few there.
“There still are 90,000 more people who need to make the decision to get vaccinated” for the state to hit the 70% mark, Baden said. “I’m hopeful we will get there by June 30.”
Christian Wihtol and Ben Botkin contributed to this report.
You can reach Lynne Terry at [email protected] or on Twitter @LynnePDX.