The good news is that about half of the population of the United States has received at least one dose of a COVID-19 vaccine. Case numbers have gone down significantly, as have hospitalizations and deaths.
The bad news is that the other half of the population hasn't been vaccinated, and many of them are uninterested in gaining immunity. This means demand is slowing, and medical professionals are having to store their vaccines over a longer period of time. There are a lot of concerns regarding storing COVID vaccines long-term, and no clinic owner wants to end up like Dr. Moma due to an inability to store their supply properly. This post is all about how to store COVID vaccines safely even as demand slows, what factors may influence demand in the future, and what comes next in general.
A Warming Demand for Cold Storage
Gone are the days when vaccine appointments were snapped up as soon as they became available and clinics didn't have to worry about long-term storage of their vaccine vials, at least in the United States. This means you can't rely on the transport containers as many pop-up clinics were able to do in the early days of the vaccine rush.
The Pfizer vaccine can be stored unmixed until its expiration date, but in this state, it requires temperatures between -80° C and -60° C (-112° F to -76° F). This is not something a regular freezer can provide. After mixing the vaccine and the diluent, vials can be kept for up to two weeks at temperatures between -25° C and -15° C.
The Moderna vaccine doesn't require temperatures that are quite as cold as the Pfizer; unpunctured vials can be stored in a refrigerator between 2° C and 8° C (36° F to 46° F) for up to 30 days, and in a medical freezer between -50° C and -15° C (-58° F and 5° F) until the expiration date. Once a vial is punctured, it can be stored at room temperature for up to 12 hours, but vials need to be discarded after that point.
Johnson & Johnson
Of the three main COVID vaccines available in the US, the Johnson & Johnson one is by far the easiest to store. Unpunctured vials require temperatures between 2° C and 8° C (36° F and 48° F) and can be stored at room temperature for up to 12 hours, while punctured vials can last up to 6 hours at room temperature before needing to be discarded.
For each of these vaccines, the CDC recommends using a purpose-built medical freezer with digital data loggers and alarms that sound during temperature excursions.
Planning for the Long Term
The point here is that each type of COVID vaccine has different storage requirements, and each one has a finite shelf life. This means that doses are beginning to expire rather than be used, thanks to the drop in demand. How should providers handle this?
States have even been turning down vaccine shipments as the national vaccination rate has been dropping nearly 20% week on week during the last few months. For many providers, this means they're more acutely aware of their vials' expiration dates than they were in March. While there's very little that individual providers can do to influence demand, they can control their supply by ensuring that they use freezers and refrigerators that comply with Vaccine Storage Standard NSF 456. The more compliant your storage method, the less vaccine is wasted, and the greater the benefit to public health as a whole.
There's good news on the horizon when considering demand for COVID vaccines, too.
The Kids Are All Right
The first thing to remember when planning your vaccine-storage strategies is that there are more than 17 million children and adolescents between the ages of 12 and 17 in the United States. While currently only the Pfizer vaccine is available to them, there was a new rush in demand among adolescents as soon as that authorization went through. The Moderna vaccine is in the last phases of proving its safety among the 12-18 crowd and is likely to receive an expanded Emergency Use Authorization sometime in June 2021. Pfizer is also doing testing to expand the reach of their vaccine to anyone ages 5 and up. All this adds up to say that vaccines that are in storage now may not be in storage very much longer.
A Lotto Interest
One of the other ways some states have been drumming up interest among the unvaccinated is holding vaccine lotteries. This started with Ohio and has spread to Oregon, Colorado, New York, and Maryland, and they work by drawing names of people who have received at least one vaccine. In Ohio specifically, the announcement of the lottery led to an immediate tripling in demand statewide. As other states adopt the lottery system — often paid for out of the budget for their vaccination public relations campaigns — expect a renewed demand for vaccines. (The odds are much higher than winning the Powerball, after all!)
It's still unclear whether COVID vaccines will need boosters, but at least one company (Novavax) has been testing a combination influenza/COVID shot. If immunity to coronavirus ends up fading with time, there will be an uptick in demand once again as people get their annual booster shots. Even if boosters don't happen annually, there's a good chance that we could be administering COVID boosters every ten years, as with tetanus shots.
But What About Now?
It's too early to determine a lot of things regarding coronavirus right now; with about 18 months of data, we don't have long-term information like we do for influenza or tuberculosis. But there are things any health care provider can do to cope with the current drops in vaccine demand. Investing in an improved medical-grade freezer is one of the best options available, as they can be used for a variety of purposes even if demand for a single vaccine were to drop to zero.