‘Better in arms than in fridges’: nurses at Victorian vaccine hubs report Pfizer wastage

Nurses working at vaccination hubs in Victoria have reported dozens of doses of the Pfizer vaccine have been wasted as the state grapples with supply shortages, while clinics are struggling to use up their doses of the AstraZeneca vaccine.

The Australian Technical Advisory Group on Immunisation (Atagi) last week updated its advice that anyone aged 60 and below should receive the Pfizer vaccine in preference over the AstraZeneca vaccine once they meet the eligibility criteria.

On Friday, the Victorian government sent a request to the federal health minister, Greg Hunt, asking for more Pfizer doses amid supply issues in the state.

Related: ‘Queue jumping’: Australians under 40 receiving Covid vaccine despite not being eligible

But a nurse told Guardian Australia that one of Victoria’s high-volume Covid vaccination centres had to dispose of 30 Pfizer doses in one day.

“People are now not turning up for Pfizer appointments, and while no one really knows all the reasons why, the booking system has been hopeless,” she said.

“One of the doctors told me he thinks people are making multiple bookings over several sites. It is also happening [elsewhere] , with appointments not being followed through with.”

She said generally the hubs were “extremely careful and diligent” about not wasting vaccines but appointment no-shows, a reduction in walk-ins and guidance that people should not receive mixed doses had made it difficult to ensure every dose was used by the end of the day.

“They are also trying to keep enough Pfizer for people’s second doses, but if these people don’t come and their vaccines have already been drawn or removed from the freezer, they have to be used that day or disposed of,” she said.

“It’s very frustrating and the doctors and nurses feel there needs to be a public education campaign about why it is so important to keep your appointment.”

The Victorian Department of Health and Human Services said the Vaccine Control Centre “has no record of any wastage of Pfizer doses” on the dates the nurse said waste had occurred.

Related: Nurses choosing better-paid shifts at vaccination hubs adding to crisis in Australian public hospitals

“The booking system only allows people to make a second appointment after they have had their first dose,” a department statement said.

A department spokesman said: “If people are unable to attend an appointment they have booked, we urge them to cancel or amend that booking as soon as possible so another Victorian can get vaccinated.”

St Vincent’s hospital, which operates the Royal Exhibition Building hub, and the Royal Melbourne hospital, which is operating the Melbourne Convention and Exhibition Centre hub, each said no Pfizer waste had occurred at their sites.

“There has been a handful of no-show appointments, but the team work on a ‘made to order’ system that allows for zero wastage,” a spokeswoman for the Royal Melbourne said.

A doctor working in a Melbourne vaccine hub said waste was occurring, though it wasn’t because people were booking multiple appointments – they simply weren’t showing up for their first one. It was unclear why they were not showing, he said.

“Another factor here is that the Pfizer vaccine has a very specific set of requirements with regard to storage and timing of use after being prepared,” he said. “There might therefore be cases where an anticipated number of vaccine doses are prepared but slightly less are given than predicted, leading to leftover doses again.”

But clinics did try to ensure doses did not go to waste, he said.

On Thursday, Hunt said the government had been told by Pfizer it would have access to 2.8m doses during the course of July, “which is in excess of what we had previously indicated”.

“We were previously expecting 600,000,” he said. “We have also requested that anything which can be brought forward, should be brought forward.”

Dr Catherine Orr, a GP working at Star Health and Prahran Town Hall in Melbourne, said less people were attending for their first dose of AstraZeneca vaccine since Atagi changed its advice. While patients were returning for their second dose of AstraZeneca, “first doses are down a lot”, she said.

As a result, the clinic was vaccinating anyone under 60 who is eligible for a vaccine so long as they have an informed consent discussion with a doctor. Orr said this had helped prevent waste.

“We have 2,000 AstraZeneca doses per [five-day] week, and are using about 300 per day of those,” she said. “But they are not wasted yet as they don’t expire for some months. We only draw up what we use.”

The head of the Australian Medical Association, Dr Omar Khorshid, said the priority needed to be on getting second doses to people who had received their first AstraZeneca jab, but “we are going to get to the point where we have excess AstraZeneca, and it can’t be allowed to expire in the fridges and never be given to anybody”.

There needs to be a plan to give this excess vaccine to vulnerable countries, he said.

In the meantime, he said he was comfortable with people under 60 calling GP clinics and hubs to see if they could get the AstraZeneca dose so long as they were taken through the risks. He said when he was speaking on ABC youth radio station Triple J about the Atagi decision, many young people rang the station saying they would be happy to receive the vaccine regardless.

“They understand the risk but they just want to be protected,” Khorshid said. “I’m very comfortable with people making an informed decision as long as they understand the science and understand what Atagi has said in terms of its recommendations.

“Vaccines are better in arms than they are in fridges, that’s for sure.”

default