Tennessee Will No Longer Send The COVID-19 Vaccine To The Shelby County Health Department (SCHD) For Allocation After A State Investigation Revealed Mismanagement And Waste Of More Than 2,400 Vaccine Doses This Month.
Photo Credit: tn.gov
Published February 24, 2021
By Vivian Jones [via The Center Square] –
Tennessee will no longer send the COVID-19 vaccine to the Shelby County Health Department (SCHD) for allocation after a state investigation revealed mismanagement and waste of more than 2,400 vaccine doses this month.
The state instead will send the doses to the city of Memphis and local hospitals.
An initial report last week of 1,300 wasted vaccine doses prompted state officials to visit the health department to get a clearer picture of how the vaccine waste occurred, Tennessee Health Commissioner Dr. Lisa Piercey said Tuesday.
On site, officials found far more vaccine doses had been wasted than previously known.
Previous reports accounted for only five doses per vial, while vials actually contain six doses. Accounting for the additional doses, officials discovered a total of 1,578 doses had expired and been thrown away in Shelby County from Feb. 3-12.
After state officials returned to Nashville on Monday, SCHD reported another expiration of 850 vaccine doses that occurred Feb. 15. The additional 850 expired doses had not been disclosed to state officials while they were on site to investigate over the weekend.
In total, about 2,400 doses of the vaccine had expired and been thrown away in Shelby County this month.
“They were not doses that were taken out into a site and then no-shows and they had to go back. These were doses that … never left the pharmacy, and were allowed to expire on site,” Piercey said.
Dr. Michelle Fiscus of the Tennessee Department of Health, who visited SCHD, explained how the waste occurred.
“When the health department requested that they get a batch of vaccines to take to a site, maybe 600 or 700, the entire 1,170-[dose] tray was defrosted, and it wasn’t necessarily told to the folks in the health department that those remaining vaccines were in the refrigerator,” Fiscus said. “Once they hit the refrigerator, the clock starts ticking. They have 120 hours to use them.
“It seems to be a breakdown of communication,” she said.
State officials also found the pharmacy contracted by the SCDH had significant issues in management and record keeping related to the COVID-19 vaccine.
Officials found a total of 51,000 vaccine doses in SCHD’s pharmacy. While some inventory is expected, Piercey said, the state estimates the department should have had only 20,000 doses in inventory. The excess 30,000 doses will all expire by March 6.
State officials found that personnel at SCHD did not have access to the pharmacy in their own building where COVID-19 vaccine doses are stored.
Further, the department did not have a process for managing soon-to-expire vaccine doses, nor did the department keep sufficient records of vaccine doses.
A federal inquiry into vaccine waste in Shelby County is likely, Piercey said. The state has made federal authorities aware of the wasted doses, but the trigger for a federal inquiry would be reporting of the waste by SCHD in a federal database.
SCHD Director Alisa Haushalter said in a statement the department is working closely with the state and the Centers for Disease Control and Prevention to “find the root causes of the incidents that led to the expiration of the vaccines.”
“We will institute safeguards to ensure it will not happen again,” Haushalter said.
In response to the situation, the Tennessee Department of Health no longer will provide vaccine doses directly to SCHD. Instead, the state will send the county’s allotment to the city of Memphis, local hospitals and clinics.
“There’s really no higher priority in the state right now than making sure that we get this right in Shelby County,” Piercey said. “The people of Shelby County deserve to have good access to vaccine.”
The Tennessee Department of Health has assigned state health staff to Shelby County to oversee vaccine administration as the state continues to investigate. The Department of Health also has requested staff from the CDC be assigned to Shelby County for 30 days.
Shelby County Mayor Lee Harris announced he had fired the manager in charge of the contract pharmacist, and the county has launched an internal investigation in addition to the state’s review.
“Although the pharmacist is not an employee of Shelby County government, we have also asked for the pharmacist to be removed,” Harris said in a statement.
Shelby County is the state’s largest population center, and receives about 14 percent of all vaccine doses statewide, Piercey said.
“The people of Shelby County deserve to have good access to vaccine, and so this is all about solving problems and making sure that we have that access,” Piercey said. “This is not about laying blame or pointing fingers.”