Startup Dr. B has created a system to prevent leftover doses of the COVID-19 vaccine from being wasted. Each day providers enter the number of doses that they have not been able to administer and the period of time in which they must do so. Immediately afterwards, an algorithm examines a list of people who have signed up for this free service and prioritizes them according to state and local criteria.
Meanwhile, in Spain, some politicians have confessed to having already vaccinated against the coronavirus with the excuse of not wasting leftover doses. But are there really too many doses left over? Who are they being administered to? Could technology help to distribute them?
The problem can appear when those in charge of administering vaccines find that they have a half-finished vial, but there are no more people to vaccinate. This situation can occur because some vaccines come in multi-dose vials. For example, the European Medicines Agency indicates that up to six doses can be drawn from each vial of Pfizer's vaccine. In the case of Moderna, up to 10 doses can be used, according to the same organization. Pablo Aldaz, vaccine spokesman for the Spanish Society of Family and Community Medicine (SemFYC ), explains that "once you open the vial, you cannot use five and leave the rest." “With those that come deep-frozen, the problem is that once you defrost them, they can no longer be frozen again,” he says.
The founder of Dr. B, Cyrus Massoumi , estimates that up to 20% or 30% of the vaccines that must be administered in the US are lost, as explained to the specialized technology portal The Verge. The system that it has developed aims to take advantage of each of these doses. "All thawed vials must be used within six hours or they will be discarded," the company stresses on its website. This newspaper has contacted the company to find out how many providers and from which parts of the United States are already using the service, but has not yet received any statements in this regard.
Anyone in the United States can sign up for a waiting list to receive leftover vaccines. So far, more than 1.6 million people have already done so, according to the company. When a provider indicates they have doses left over, the system looks at all of these people who has priority to receive the vaccine based on state and local criteria. The service sends text messages to those with nearby zip codes. If a user receives this message, they must respond in the time indicated to claim the dose and receive the exact location where they will receive the vaccine. "If you reject or do not respond, we will reassign that dose to another person," says the company.
The virologist of the coronavirus laboratory of the National Center for Biotechnology (CNB-CSIC) Isabel Solá affirms that "the United States data of between 20 % and 30% of missed appointments is unacceptable in a situation like the current one, with a shortage of available vaccines and with a population that needs to be vaccinated as soon as possible ”. “It is essential to optimize vaccination and avoid losing doses due to organizational problems, so it seems to me that the proposed system is an excellent idea. Artificial intelligence algorithms are, without a doubt, a very powerful tool to solve the problem ”, he comments.
The situation in Spain
Would such a system make sense in Spain? José Antonio Forcada, nurse and president of the National Association for Nursing and Vaccines (ANENVAC), explains that vaccination planning in the US is completely different than in Spain and other European countries. At this time in Spain, if the Autonomous Communities do good planning, they consider that “a system of this type is neither necessary nor convenient”.
“The Americans are putting out a huge volume of vaccines. They put two million vaccines a day and their system is different. They call, they sign up on a list and there are even people who if they go to the vaccination center and meet the criteria, they get vaccinated ”, says Aldaz. In Spain the goal is to immunize 2.3 million people in about 12 weeks. Africa González Fernández , professor of Immunology at the Center for Biomedical Research (CINBIO), confirms that in Spain "massive calls are not being made as if other countries such as the United States".
In the case of the United States, González understands that they may have problems "since they make massive calls to thousands of people who go to places with tents or from the car." "If you have a forecast that for example 1,000 people will go, prepare all the vaccines and only 900 attend, it is important to have an agile, flexible and fast system to put the other 100 and that they do not get lost." Among the disadvantages that a system of this type can have, González mentions inequality, since "younger people with access to this type of computer system or with more resources would have easier access."
But in Spain, according to account , vaccination "is being done little by little". “We have barely more than 3% of people vaccinated with two doses. They are already getting three different vaccinations and Janssen's is coming soon. What we need is to have more vaccines, "he says. Forcada agrees with her that "in Spain there are not excess doses, they are lacking." In addition, as he explains, you should always have a waiting list. Thus, if someone does not go to be vaccinated when they have been summoned, it is possible to “urgently locate people to receive these doses.”
“The important thing is that these people on the waiting list have the same conditions as those who have not received them. received ”, he adds. The problem of the remaining doses did occur at the beginning of the vaccination campaign, as Forcada recalls: “It led to unpleasant situations where people who should not receive the vaccine were vaccinated while people who really needed it were left unvaccinated. ".
Aldaz is director of a basic health zone in Pamplona and assures that" no vaccine is ever thrown away. " According to his account, each day they calculate the doses they are going to administer and have a reserve list of people who live very close to the vaccination point in case someone does not come to their appointment. “Of each list, which were about 100 or 200 every day, at most two were missing. Some even warned that they would not be able to go, ”he points out.
Although the experts consulted now do not see the need to implement a system of this type in Spain, they argue that it could be useful in a possible scenario of mass vaccination. “Until now, the vaccinated population has been highly selected: few and in great need to vaccinate. They were all very motivated because they were older people and they have responded very well ”, says Aldaz, who is also part of the technical group of the Federation of Spanish Scientific Medical Associations (FACME) that advises the Ministry of Health on the vaccination strategy against the Covid-19.
But in April the scenario that arises "is different because we are going to have many more vaccines." Aldaz acknowledges that if there are massive vaccinations, "it is foreseeable that there will be more failures due to a matter of numbers." In that case, "an artificial intelligence system would certainly come in handy to alert us that there are some gaps left". "As soon as we have more possibility to vaccinate, we have to think about something similar," he says. Forcada argues that perhaps when the expected millions of doses are received, if the system were not capable of controlling all the lists of people to be vaccinated, it would be possible to resort to a system of these characteristics. Even so, consider that this situation is "unlikely".
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