Providers aren’t barred from vaccinating non-priority groups, but equity questions arise

While pharmacies may give away leftover COVID-19 vaccines and are encouraged to not let any doses go to waste, questions of equitable distribution arise as some in non-priority groups look for vaccine.



Photo of Jasmina Arnaut.

Sabine Martin, News Reporter

University of Iowa College of Pharmacy student Jasmina Arnaut said many of her friends are asking her where to find extra doses of the COVID-19 vaccine that would otherwise be expired at the end of a pharmacy workday.

“They know I’m in the [UI pharmacy] program. They’re asking me if any pharmacies around the area are offering vaccinations, and a lot of them are,” Arnaut said.

The Iowa Department of Public Health’s website states that Iowa is currently vaccinating individuals who qualify in Phase 1B. This group includes people ages 65 and older, people under 65 with underlying health conditions, and those in critical front-line roles. Iowa is expected to open vaccine eligibility to every adult April 5.

Johnson County Community Health Manager Sam Jarvis told the *The Daily Iowan* in an email that the practice of “no wasted doses” has become a common mindset in the nation.

“It is absolutely allowable and understandable as nobody wants to see a wasted dose,” Jarvis wrote.

According to a vaccine shortage order put in effect on March 8 by Gov. Kim Reynolds, a vaccine provider who has vaccine supply remaining after the Phase 1A population has been fully vaccinated may immediately provide the vaccine for individuals in Phase 1B. And vaccine providers have an incentive to make sure all of the vaccine is used. Two of the vaccines emergency approved by the Food and Drug Administration must be used quickly once unthawed — the Pfizer-BioNtech vaccine, for example, must be used within 6 hours of being mixed with a diluent. Virus researchers in Iowa have said each person vaccinated prevents further infection and mutation of the virus. Plus, counties could have vaccine withheld if they don’t use at least 80 percent of their vaccine allotment. The state almost withheld a shipment to five Iowa counties that didn’t meet the 80 percent threshold before ultimately allowing them to still receive their shipment.

“Residual vaccine from vials that would otherwise have to be discarded may be used to vaccinate a person who is included in a phase that has not yet been activated only if necessary to avoid vaccine waste,” the order states.

Jarvis wrote that at points in time, however, those who search for extra vaccines have caused some frustration.

“It appears persons are ‘cutting in line’ and nobody likes that,” he wrote.

Arnaut said following vaccination hubs online and on social media is the best way to find out where extra doses are. She said those who are currently eligible for a COVID-19 vaccination can sign up for waitlists in their area online.

Barbara Badovinac, a first-year student at the UI Carver College of Medicine, said she called pharmacies around Iowa to search for an extra dose of the COVID-19 vaccine. After a few weeks of calling different pharmacies, Badovinac said she drove two hours to get vaccinated at a Hy-Vee in West Des Moines. Several first-year medical students drove to a Des Moines Hy-Vee for the vaccine, which in February was allowing medical students to make appointments as health care workers.

RELATED: Kim Reynolds expects all Iowans to be eligible for vaccines by April 5

“I would have wished that it was not the case, that I could have just gotten vaccinated here, but it was worth it,” Badovinac said.

Badovinac was eligible to get vaccinated at the Hy-Vee in West Des Moines because of her clinical experience at medical school. She said Hy-Vee pharmacies in Johnson County did not list her as eligible for the vaccine.

“I have heard from multiple people that Hy-Vee was vaccinating in different counties and interpreted the CDC guidelines a little differently,” she said.

At the UI Faculty Council meeting on March 9, UI Campus Health Officer Dan Fick said many of the pharmacies that are participating in the federal level of vaccination don’t have the ability to look in medical records for pre-existing conditions, so it’s patient attestation.

“The long and short of that is they have a patient click the button that they were in one of these groups then they could potentially get a vaccine,” Fick told the Faculty Council.

In Johnson County, Jarvis wrote that the county’s hospital and pharmacy efforts have put in the effort to make sure extra doses or “no-show” appointments don’t disrupt the vaccination distribution to prioritized groups.

“Johnson County Public Health and our partners have coordinated to have a ‘buffer’ for the persons we’re coordinating to be vaccinated,” he wrote.

Reynolds announced on Wednesday that Iowa will allow all residents 16 and older to be eligible by April 5, if supply levels continue as they are now.

Arnaut said she doesn’t believe in the rhetoric that someone can take a vaccine away from someone else, but that it is important to get people who are prioritized vaccinated first.

“In a perfect world, I’d love for anyone and everyone to get vaccinated, right away,” Arnaut said. “But I also believe that it’s important to get to communities who cannot get vaccinated or people who are at higher risk.”