Thousands of COVID-19 doses set to expire while millions of Canadians haven't signed up for a shot

Toronto pharmacist Kyro Masehfaceda difficult taskon Tuesday. He had to toss 330 doses of the Moderna vaccine thatexpired before he could get enough people to sign up for a shot.

"It feels sinful to throw these out," he said. "This shouldn't be happening. It hurts."

In the early days of Canada's COVID-19 vaccination campaign, the main hurdle was having enough vaccines to meet demand. But now that a majority of Canadians havereceivedtheir shots, pharmacists and health-care providers face a new challenge: getting enough people to sign up for a dose before their available supply expires.

"It's a whole different situation now," said Regina-based infectious disease physician Dr. Alexander Wong, whose clinic tossed eightexpired Moderna doses last week.

"Now we're dealing with everybody that's left [those with]questions, [the]hesitant... It's going to require outside-the-box thinking to better engage these people."

Limited shelf life

Eightyper cent of Canadianseligible to get vaccinated have received at least one dose, and close to 64 per cent are fully vaccinated. That still leaves more than 6.5 million peoplewho have yet to get a single shot at a time whenCOVID-19 infections areticking upwardin Canada.

In the past two months, Canada received millions of Moderna doses from the U.S., but not all of them will be put to use before they expire.

The Ontario Pharmacists Associationsaid pharmacists in the province will likely have to throw outthousands of expired Moderna doses over the course of this week and the next due to declining demand.

Vials of Modernacanbe stored in the freezer for up to six months. But they arrive in a thawed state at pharmacies, and can only last in the fridge for 30 days, said the association's CEO Justin Bates. And once a vial is punctured to withdraw a dose, the remaining doses typically around 13expire in 24 hours.

Bates said another hurdleis that some peoplewho got the Pfizer-BioNTech vaccine for their first shot are refusingto get Modernafor their second dose, becausesome countries including the United States don't recognize people with mixed doses as being fully vaccinated.

"There's still a significant hesitancy related to Moderna, and mixing in general, which has led to the potential of wastage," he said.

'Terrible situation'

Bates said Ontario pharmacists are doing their best to use up expiring Moderna doses, includingsendingsome to pharmacieswith higher demand and educating customers on the benefits of vaccination.

"No health-care provider wants to be put in this position where they have to contemplate disposal of vaccines," said Bates. "It's a terrible situation to be in and we've done everything we can to avoid wastage."

Ontario'sMiddlesex-London Health Unit (MLHU) is also scrambling to avoid discarding doses. It has around 15,000 Moderna doses set to expireon Aug. 12 just six days away.

MLHU says it received a big Moderna shipment inJuly, but didn't have enough room to store it in the freezer. And because demand was high at the time, the health unitexpected the vaccineswould be used up quickly.

Now that demand has waned, the MLHUis hoping to drum up interest by accepting walk-ins and setting up pop-up clinics.

"We right now are doing everything possible to make vaccination as simple and as accessible as we can,"said Dr. Chris Mackie, MLHU's medical officer of health.

What about donating doses?

Maseh, the Toronto pharmacist, said he would like to see Canada donate unwanted doses to developing countries that urgently need them.

"We're just [going to] toss this in the trash while other people die," he said. "This is not fair."

But shipping soon-to-expire vaccine doses to other countries poses challenges of its own given their limited shelf life.

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Despite Canada having one of the highest vaccination rates in the world, that might not be enough to slow the spread of COVID-19 driven by the highly contagious delta variant.

Global Affairs Canada, which is involved in the vaccination effort,told CBC News it's aware that a "small number" of vaccine doses in Canada will soon expireandsaidit may not be possible to redistribute them.

However, the federal department said the rate of COVID-19 vaccine waste in Canada is low at a rate of less than 1 per cent.

"Careful planning, training and sharing of best practices across provinces and territories has helped to minimize avoidable wastage," spokesperson Ciara Trudeau said in an email."Canada is determined to use our vaccine supply efficiently and effectively."

What about offering third doses?

News ofvaccine doses going unusedhas prompted some Canadians who received different vaccines for their first and second shots to question why they can't receivea third shot, given some countries have refused to recognise mixed doses as complete vaccination.

"Why let those doses go to waste?" said Louise Jacob of Ottawa, who got a mix of AstraZeneca and Moderna vaccines.

Jacob booked a Caribbean cruise with Norwegian Cruise Line departingfrom Florida in January. She said she'll have to cancel in early October when full payment is due if the cruise linemaintains its policy of refusing to recognize people with mixed doses as being fully vaccinated.

To alleviate thoseconcerns, Jacob said she'swilling to sign up for a third dose of Moderna if no one else wantedit.

"Why doesn't the government offer it to people like me?" she asked.

Last month, the Quebec government saidit isoffering a third vaccine dose to people who have an essential trip planned to a country that doesn't recognize their vaccination status.

The Ontario government has saidit has no plans to follow suit, and the federal governmentisn't recommending a third shotat this time.

"We don't really know the exact impact of adding another dose," saidChief Public Health Officer Dr. Theresa Tam at a news conference on Thursday.