As President Joe Biden convenes heads of state for a COVID-19 summit on Wednesday, pressure is growing on American drug companies — particularly Moderna, the upstart biotech firm that developed its coronavirus vaccine with billions of dollars in taxpayer money — to share their formulas with manufacturers in nations that desperately need more shots.

Last year’s successful race to develop vaccines in extraordinarily short order put companies like Moderna and Pfizer in a highly favourable spotlight. But now, with less than 10% of those in many poor nations fully vaccinated and a dearth of doses contributing to millions of deaths, health officials in the United States and abroad are pressing the companies to do more to address the global shortage.

The Biden administration has privately urged both Pfizer and Moderna to enter into joint ventures where they would license their technology to contract manufacturers with the aim of providing vaccines to low- and middle-income countries, according to a senior administration official.

Those talks led to an agreement with Pfizer, announced on Wednesday, to sell the United States an additional 500 million doses of its vaccine at a not-for-profit price — rather than license its technology — to donate overseas.

The discussions with Moderna have not been fruitful, said the official, who expressed deep frustration with the company but requested anonymity to discuss sensitive information.

A coalition of major drug and vaccine manufacturers in developing countries around the world is drafting an appeal to Biden asking him to press the companies more aggressively to share the formulations and processes used to make their vaccines.

The World Health Organization has also had trouble getting Moderna to the negotiating table, according to Dr Martin Friede, a WHO official, and Charles Gore, who runs a United Nations-backed nonprofit organization, Medicines Patent Pool. Both are working with a WHO-backed technology transfer hub in South Africa to set up to teach manufacturers from developing countries how to make mRNA vaccines, a new type of vaccine technology used by both American companies.

“We would love to get a discussion with Moderna, about a license to their intellectual property. This would make life so much simpler, but for the moment all attempts have resulted in no reply,” Friede said.

At Wednesday’s virtual summit, on the sidelines of the United Nations General Assembly meeting in New York, Biden will convene heads of state, drug company executives, philanthropic groups and nongovernmental organizations to encourage them to work together toward vaccinating 70% of the world’s population by this time next year, according to a draft document the White House sent to the summit participants.

Global health advocates say Moderna has a special obligation to share its technology because its vaccine relies in part on technology developed by the National Institutes of Health, and because the company accepted $2.5 billion from the federal government as part of Operation Warp Speed, the Trump administration’s fast-track vaccine initiative.

A Moderna spokesperson, Colleen Hussey, said in an email message Tuesday night that the company had agreed not to enforce its COVID-related patents and was “willing to license our intellectual property for COVID-19 vaccines to others for the post-pandemic period.”

But advocates say the world needs Moderna’s know-how now — not after the pandemic is over.

While sharing the vaccine “recipe” is a vital first step, it is not in and of itself enough to allow for the swift and efficient setup of new mRNA manufacturing locations, said Alain Alsalhani, a vaccines expert with Doctors Without Borders’ access-to-medicines campaign.

“You need someone to share all the process, because it’s a new technology,” he said. “One of the problems we have is that the scientific literature about industrial-scale manufacturing of mRNA vaccines is so slim. This is why it’s not just about a recipe, it’s about an active and full tech transfer.”

Pfizer, in an emailed statement, noted that it and its partner, BioNTech, had signed a letter of intent, announced last month, with the South African biopharmaceutical company Biovac, which is part of the South African hub, to manufacture Pfizer’s vaccine for African nations. But Biovac will only bottle the vaccine, which does not necessitate sharing the formula. The actual “drug substance” will be made in Europe.

Some pharmaceutical executives have suggested the South African hub may not be ready to manufacture vaccines. But a recent site visit by WHO officials found that both Afrigen, the hub’s teaching facility, and Biovac are both “fit for purpose,” according to a summary of the visit, obtained by The New York Times. The summary said Afrigen’s team is “competent and experienced” and has developed a plan for a “robust mRNA vaccine production process, which will be transferred to Biovac.”

In the absence of voluntary cooperation from the companies, some legal experts and global health advocates say the Biden administration could attempt to force them to share their intellectual property, using the powers of the Defense Production Act, a 1950 law that gives the president broad power over American companies in emergency situations.

Lawrence O. Gostin, a public health law expert at Georgetown University, said Biden could declare the pandemic a national security threat, which would enable him to “require companies to sign technology transfer contracts in exchange for reasonable compensation,” from either the federal government or manufacturing partners.

“Moderna accepted substantial federal funding under Operation Warp Speed and both Pfizer and Moderna benefited from NIH dollars for the basic research over a decade for mRNA technology,” Gostin said, adding that the companies “hold a special social and ethical responsibility to share that technology for the benefit of the world.”

Biden administration officials say that forcing the companies to act is not as simple as it sounds, and that an effort to compel them to share their technology would invariably lead to a drawn-out legal battle, which would be counterproductive.

Pfizer and Moderna executives have said that the mRNA production process is so complex, and that there are so few people with experience in it available, that setting up new operations in other parts of the world would not be feasible and could not happen quickly enough to be useful. They say that their combined manufacturing will produce more than enough vaccines to meet global need by the middle of next year and that the fastest way to address vaccine inequity would be through distribution of donated doses.

But some pharmaceutical manufacturing experts and drug-access advocates argue that the events of the past 18 months make it clear that manufacturing in developing countries is going to be crucial to ensuring equitable access.

Many of the donated doses bound for use in Africa, for example, were meant to come from the Serum Institute of India. But five months ago, the Indian government blocked the company from exporting any vaccines, ordering that the supply instead be directed to trying to stanch a raging second COVID wave in that country. (India now says it will allow exports to resume next month.)

“We keep hearing, ‘The vaccines are coming, the vaccines are coming,’ but 3 million people have died since the Pfizer vaccine was first authorized by the FDA,” said Zain Rizvi, an expert on access to medicines with the advocacy organization Public Citizen.

Moderna and Pfizer have a direct financial interest in keeping their technology to themselves and guarding a competitive advantage not just in the sale of COVID vaccines, which are on track to bring in more than $53 billion in revenue this year, but also other potentially lucrative mRNA vaccines in development, such as one for cancer, HIV and malaria, he said, adding, “They don’t want to stand up a future competitor.”

The coalition of drugmakers in developing countries that is drafting an appeal to Biden plans to ask the U.S. government to pressure companies for several things: a license for the intellectual property, a license for the technology involved in the manufacturing of the vaccines, the provision of items such as cell lines and assistance in acquiring vital but scarce equipment.

In exchange for sharing its process, Moderna would be compensated with a licensing fee, a percentage of each dose sold.

Even without Moderna’s cooperation, WHO says its tech transfer hub in South Africa will focus on trying to replicate as closely as possible the Moderna formula, as the gold standard against which to compare candidates from other biotechnology companies, and then teach any manufacturer who wants to make it how to do so at scale.

“If we had Moderna or BioNTech with us, we could get to an approved vaccine in 18 months, but without them we have to go through full development — so it’s 36 months if everything goes perfectly, but it could be longer,” said Friede, who heads the WHO’s Initiative for Vaccine Research.

Pfizer and Moderna are at a pivotal moment where they can decide what role they want to play in the process, he said. “I’ve made many successful vaccines; with me I have other people who have made successful vaccines,” he said. “What we are actually saying is: ‘We’re going to do this. So you can come in and try and maintain some control by actually producing vaccines locally, or we’re going to do it without you. And then you’ve lost control’.”

As President Joe Biden convenes heads of state for a COVID-19 summit on Wednesday, pressure is growing on American drug companies — particularly Moderna, the upstart biotech firm that developed its coronavirus vaccine with billions of dollars in taxpayer money — to share their formulas with manufacturers in nations that desperately need more shots.

As President Joe Biden convenes heads of state for a COVID-19 summit on Wednesday, pressure is growing on American drug companies — particularly Moderna, the upstart biotech firm that developed its coronavirus vaccine with billions of dollars in taxpayer money — to share their formulas with manufacturers in nations that desperately need more shots. Last year’s successful race to develop vaccines in extraordinarily short order put companies like Moderna and Pfizer in a highly favourable spotlight. But now, with less than 10% of those in many poor nations fully vaccinated and a dearth of doses contributing to millions of deaths, health officials in the United States and abroad are pressing the companies to do more to address the global shortage. The Biden administration has privately urged both Pfizer and Moderna to enter into joint ventures where they would license their technology to contract manufacturers with the aim of providing vaccines to low- and middle-income countries, according to a senior administration official. Those talks led to an agreement with Pfizer, announced on Wednesday, to sell the United States an additional 500 million doses of its vaccine at a not-for-profit price — rather than license its technology — to donate overseas. The discussions with Moderna have not been fruitful, said the official, who expressed deep frustration with the company but requested anonymity to discuss sensitive information. A coalition of major drug and vaccine manufacturers in developing countries around the world is drafting an appeal to Biden asking him to press the companies more aggressively to share the formulations and processes used to make their vaccines. The World Health Organization has also had trouble getting Moderna to the negotiating table, according to Dr Martin Friede, a WHO official, and Charles Gore, who runs a United Nations-backed nonprofit organization, Medicines Patent Pool. Both are working with a WHO-backed technology transfer hub in South Africa to set up to teach manufacturers from developing countries how to make mRNA vaccines, a new type of vaccine technology used by both American companies. “We would love to get a discussion with Moderna, about a license to their intellectual property. This would make life so much simpler, but for the moment all attempts have resulted in no reply,” Friede said. At Wednesday’s virtual summit, on the sidelines of the United Nations General Assembly meeting in New York, Biden will convene heads of state, drug company executives, philanthropic groups and nongovernmental organizations to encourage them to work together toward vaccinating 70% of the world’s population by this time next year, according to a draft document the White House sent to the summit participants. Global health advocates say Moderna has a special obligation to share its technology because its vaccine relies in part on technology developed by the National Institutes of Health, and because the company accepted $2.5 billion from the federal government as part of Operation Warp Speed, the Trump administration’s fast-track vaccine initiative. A Moderna spokesperson, Colleen Hussey, said in an email message Tuesday night that the company had agreed not to enforce its COVID-related patents and was “willing to license our intellectual property for COVID-19 vaccines to others for the post-pandemic period.” But advocates say the world needs Moderna’s know-how now — not after the pandemic is over. While sharing the vaccine “recipe” is a vital first step, it is not in and of itself enough to allow for the swift and efficient setup of new mRNA manufacturing locations, said Alain Alsalhani, a vaccines expert with Doctors Without Borders’ access-to-medicines campaign. “You need someone to share all the process, because it’s a new technology,” he said. “One of the problems we have is that the scientific literature about industrial-scale manufacturing of mRNA vaccines is so slim. This is why it’s not just about a recipe, it’s about an active and full tech transfer.” Pfizer, in an emailed statement, noted that it and its partner, BioNTech, had signed a letter of intent, announced last month, with the South African biopharmaceutical company Biovac, which is part of the South African hub, to manufacture Pfizer’s vaccine for African nations. But Biovac will only bottle the vaccine, which does not necessitate sharing the formula. The actual “drug substance” will be made in Europe. Some pharmaceutical executives have suggested the South African hub may not be ready to manufacture vaccines. But a recent site visit by WHO officials found that both Afrigen, the hub’s teaching facility, and Biovac are both “fit for purpose,” according to a summary of the visit, obtained by The New York Times. The summary said Afrigen’s team is “competent and experienced” and has developed a plan for a “robust mRNA vaccine production process, which will be transferred to Biovac.” In the absence of voluntary cooperation from the companies, some legal experts and global health advocates say the Biden administration could attempt to force them to share their intellectual property, using the powers of the Defense Production Act, a 1950 law that gives the president broad power over American companies in emergency situations. Lawrence O. Gostin, a public health law expert at Georgetown University, said Biden could declare the pandemic a national security threat, which would enable him to “require companies to sign technology transfer contracts in exchange for reasonable compensation,” from either the federal government or manufacturing partners. “Moderna accepted substantial federal funding under Operation Warp Speed and both Pfizer and Moderna benefited from NIH dollars for the basic research over a decade for mRNA technology,” Gostin said, adding that the companies “hold a special social and ethical responsibility to share that technology for the benefit of the world.” Biden administration officials say that forcing the companies to act is not as simple as it sounds, and that an effort to compel them to share their technology would invariably lead to a drawn-out legal battle, which would be counterproductive. Pfizer and Moderna executives have said that the mRNA production process is so complex, and that there are so few people with experience in it available, that setting up new operations in other parts of the world would not be feasible and could not happen quickly enough to be useful. They say that their combined manufacturing will produce more than enough vaccines to meet global need by the middle of next year and that the fastest way to address vaccine inequity would be through distribution of donated doses. But some pharmaceutical manufacturing experts and drug-access advocates argue that the events of the past 18 months make it clear that manufacturing in developing countries is going to be crucial to ensuring equitable access. Many of the donated doses bound for use in Africa, for example, were meant to come from the Serum Institute of India. But five months ago, the Indian government blocked the company from exporting any vaccines, ordering that the supply instead be directed to trying to stanch a raging second COVID wave in that country. (India now says it will allow exports to resume next month.) “We keep hearing, ‘The vaccines are coming, the vaccines are coming,’ but 3 million people have died since the Pfizer vaccine was first authorized by the FDA,” said Zain Rizvi, an expert on access to medicines with the advocacy organization Public Citizen. Moderna and Pfizer have a direct financial interest in keeping their technology to themselves and guarding a competitive advantage not just in the sale of COVID vaccines, which are on track to bring in more than $53 billion in revenue this year, but also other potentially lucrative mRNA vaccines in development, such as one for cancer, HIV and malaria, he said, adding, “They don’t want to stand up a future competitor.” The coalition of drugmakers in developing countries that is drafting an appeal to Biden plans to ask the U.S. government to pressure companies for several things: a license for the intellectual property, a license for the technology involved in the manufacturing of the vaccines, the provision of items such as cell lines and assistance in acquiring vital but scarce equipment. In exchange for sharing its process, Moderna would be compensated with a licensing fee, a percentage of each dose sold. Even without Moderna’s cooperation, WHO says its tech transfer hub in South Africa will focus on trying to replicate as closely as possible the Moderna formula, as the gold standard against which to compare candidates from other biotechnology companies, and then teach any manufacturer who wants to make it how to do so at scale. “If we had Moderna or BioNTech with us, we could get to an approved vaccine in 18 months, but without them we have to go through full development — so it’s 36 months if everything goes perfectly, but it could be longer,” said Friede, who heads the WHO’s Initiative for Vaccine Research. Pfizer and Moderna are at a pivotal moment where they can decide what role they want to play in the process, he said. “I’ve made many successful vaccines; with me I have other people who have made successful vaccines,” he said. “What we are actually saying is: ‘We’re going to do this. So you can come in and try and maintain some control by actually producing vaccines locally, or we’re going to do it without you. And then you’ve lost control’.”

Pressure grows on US companies to share Covid vaccine technology

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After weeks of waiting, Judy Franke’s vaccine breakthrough came when her phone rang at 8 p.m. one freezing February night. There were rumors of extra doses at the Minneapolis convention center. Franke, 73, had an hour to get there. No guarantees.

“I called my daughter and she said, ‘I’m putting my boots on right now,’” said Franke, a retired teacher with a weakened immune system. “You need to go find the vaccine because the vaccine’s not going to find you.”

The clamor for hard-to-get COVID-19 vaccines has created armies of anxious Americans who have resorted to hunting for leftovers on the fringes of the country’s patchwork vaccination system.

They haunt pharmacies at the end of the day in search of an extra, expiring dose. They drive from clinic to clinic hoping that someone was a no-show to their appointment. They cold-call pharmacies like eager telemarketers: Any extras today? Maybe tomorrow?

Some pharmacists have even given them a nickname: Vaccine lurkers.

Even with inoculation rates accelerating and new vaccines entering the market, finding a shot remains out of reach for many, nearly three months into the country’s vaccination campaign. Websites crash. Appointments are scarce. Severe weather like last month’s winter storms can wreak havoc on shipments. Many Americans have been left feeling like they are on their own.

“There are people who feel desperate, and this is what they end up doing,” said Dr. Ashish K. Jha, dean of the Brown University School of Public Health. “It’s ridiculous. It’s wholly unnecessary. There should be a way to do this that does not require us going down this path.”

The leftover shots exist because the Moderna and Pfizer vaccines have a limited life span once they are thawed and mixed. When no-shows or miscalculations leave pharmacies and clinics with extras, they have mere hours to use the vaccines or risk having to throw them away.

And so, tens of thousands of people have banded together on social media groups under one mantra: Better in an arm than in the trash. They trade tips about which Walmarts have extra doses. They report on whether besieged pharmacies are even answering the phone. They speculate about whether a looming blizzard might keep enough people home to free up a slot.

In Denver, suburban teachers stampeded a mass-vaccination site after they got an email saying they had an hour to claim 200 unused doses. In Massachusetts, hourslong lines wrapped around a DoubleTree Hotel after reports of extras ping-ponged across social media.

“It’s like buying Bruce Springsteen tickets,” said Maura Caldwell, who started a Minneapolis Vaccine Hunter Facebook group to help people navigate the search for appointments. The group now has 20,000 members. “It’s not easy. You can’t just sign up.”

Thousands of doses have already gone to waste because of power failures, paperwork mix-ups and a shifting jumble of state and local guidelines about what to do with leftovers. Earlier this year, health officials in California and New York state loosened their rules for who could be vaccinated when vaccines are about to expire.

Other health workers have distributed leftovers on their own. In Oregon, a vaccination team stranded on a snowbound highway went from car to car offering doses that would go bad in six hours. A doctor in Houston received national attention after he was fired for racing to inoculate 10 people — including his wife — before his vial of extra doses expired.

The pace of vaccinations has picked up to about 1.9 million doses per day, with more due as the single-shot Johnson &amp;amp; Johnson vaccine rolls out. But health experts said the scavenger hunt for leftovers highlights the persistent disparities in America’s vaccination rollout, where access to lifesaving medicine can hinge on computer savvy, personal connections and a person’s ability to drop everything to snag an expiring dose.

In Dallas, Kimberly White-Agent said she had struggled to find appointments for her brother and 83-year-old stepfather, even after city and federal officials opened a mass-vaccination site to serve their largely Black neighborhood. She resorted to putting them on wait lists and hoping an extra slot opened up.

“It’s like a mirage,” she said.

Some of the leftover chasers are not yet eligible to sign up for appointments. Others are old enough or sick enough to qualify, but said that overloaded vaccination websites and endless hold lines convinced them to abandon the official channels and search for themselves.

Gunnar Esiason, 29, has cystic fibrosis and said he was not about to wait until his New Hampshire vaccine appointment rolled around on April 21. So he started showing up at Walgreens pharmacies and state-run vaccination sites — wherever there was a whiff of an extra vaccine, until he got a tip that a Dartmouth medical center had a few extras.

“I knew I was going to a lot of ‘No’s,’” he said. “All I needed was one ‘Yes.’”

In Minnesota, Franke signed up for eight different vaccine lists managed by doctors, Walgreens, Walmart, even a state lottery, but said nobody called. Then last month, she got a tip that the mass-vaccination site at the convention center might have some extras.

There were about 20 other people already milling around in the lobby when Franke arrived, she said, and a health worker quickly emerged to inform them there were no leftovers.

But many in the crowd stuck around, and after a half-hour, the vaccination team allowed people 65 and older, teachers and emergency responders to get their shots. Franke lined up and said she cried with relief on the car ride home to the suburbs.

Ashok Shah, 77, a retired internal-medicine physician in Poughkeepsie, New York, tried to sign up. But failed again and again.

Shah said he and his 79-year-old wife spent weeks languishing on their county’s official vaccination lists. He would search fruitlessly for online appointments in the middle of the night, and put himself on informal wait lists kept by nearby pharmacies.

When it became clear there would be little progress, “We had to go looking,” he said.

In early February, with 6 inches of fresh snow on the ground and a nearly impassable mound plowed into the base of his driveway, he said a Rite Aid called with the news that they had one spare dose.

“I said, I’ll take it,” said Shah, who got his second dose Tuesday. “Come rain, come shine, come snow, I’ll be there.”

But leftovers are getting harder and harder to find. More people are looking, and the extras are dwindling as pharmacies and public-health agencies get better at matching each day’s available vials with their list of appointments.

Vaccine teams in Fairfax County, Virginia, fill up individual syringes from a shared supply of vaccines to make sure they are not cracking open new vials at the end of the day. Several cities have created special leftover lists to offer doses to police officers, teachers or older people. Columbus, Ohio, said its “no waste” list of 250 people is full.

At Discount Drug Mart, a chain of 76 pharmacies in Ohio, the vaccination teams add up their doses against no-shows throughout the day, and start reaching out early to the 25 people who are on their rolling standby lists. Rarely, someone waiting in the parking lot at 9 p.m. or calling on a whim may land a vaccine.

“It’s a priority to never waste a dose,” said Jason Briscoe, the company’s director of pharmacy operations.

Often, the hunt just amounts to days of frustration. Sara Stoltz has spent days driving around Dallas trying to get a leftover dose for her 64-year-old mother. They get turned away from pharmacies whose wait lists are already full at 200 people deep. They stop at every Walmart they can, only to learn that nobody missed an appointment.

“I keep hearing rumors,” Stoltz said, with no dose behind them. “It’s like one of those urban myths.”

After weeks of waiting, Judy Franke’s vaccine breakthrough came when her phone rang at 8 p.m. one freezing February night. There were rumors of extra doses at the Minneapolis convention center.

After weeks of waiting, Judy Franke’s vaccine breakthrough came when her phone rang at 8 p.m. one freezing February night. There were rumors of extra doses at the Minneapolis convention center. Franke, 73, had an hour to get there. No guarantees. “I called my daughter and she said, ‘I’m putting my boots on right now,’” said Franke, a retired teacher with a weakened immune system. “You need to go find the vaccine because the vaccine’s not going to find you.” The clamor for hard-to-get COVID-19 vaccines has created armies of anxious Americans who have resorted to hunting for leftovers on the fringes of the country’s patchwork vaccination system. They haunt pharmacies at the end of the day in search of an extra, expiring dose. They drive from clinic to clinic hoping that someone was a no-show to their appointment. They cold-call pharmacies like eager telemarketers: Any extras today? Maybe tomorrow? Some pharmacists have even given them a nickname: Vaccine lurkers. Even with inoculation rates accelerating and new vaccines entering the market, finding a shot remains out of reach for many, nearly three months into the country’s vaccination campaign. Websites crash. Appointments are scarce. Severe weather like last month’s winter storms can wreak havoc on shipments. Many Americans have been left feeling like they are on their own. “There are people who feel desperate, and this is what they end up doing,” said Dr. Ashish K. Jha, dean of the Brown University School of Public Health. “It’s ridiculous. It’s wholly unnecessary. There should be a way to do this that does not require us going down this path.” The leftover shots exist because the Moderna and Pfizer vaccines have a limited life span once they are thawed and mixed. When no-shows or miscalculations leave pharmacies and clinics with extras, they have mere hours to use the vaccines or risk having to throw them away. And so, tens of thousands of people have banded together on social media groups under one mantra: Better in an arm than in the trash. They trade tips about which Walmarts have extra doses. They report on whether besieged pharmacies are even answering the phone. They speculate about whether a looming blizzard might keep enough people home to free up a slot. In Denver, suburban teachers stampeded a mass-vaccination site after they got an email saying they had an hour to claim 200 unused doses. In Massachusetts, hourslong lines wrapped around a DoubleTree Hotel after reports of extras ping-ponged across social media. “It’s like buying Bruce Springsteen tickets,” said Maura Caldwell, who started a Minneapolis Vaccine Hunter Facebook group to help people navigate the search for appointments. The group now has 20,000 members. “It’s not easy. You can’t just sign up.” Thousands of doses have already gone to waste because of power failures, paperwork mix-ups and a shifting jumble of state and local guidelines about what to do with leftovers. Earlier this year, health officials in California and New York state loosened their rules for who could be vaccinated when vaccines are about to expire. Other health workers have distributed leftovers on their own. In Oregon, a vaccination team stranded on a snowbound highway went from car to car offering doses that would go bad in six hours. A doctor in Houston received national attention after he was fired for racing to inoculate 10 people — including his wife — before his vial of extra doses expired. The pace of vaccinations has picked up to about 1.9 million doses per day, with more due as the single-shot Johnson &amp; Johnson vaccine rolls out. But health experts said the scavenger hunt for leftovers highlights the persistent disparities in America’s vaccination rollout, where access to lifesaving medicine can hinge on computer savvy, personal connections and a person’s ability to drop everything to snag an expiring dose. In Dallas, Kimberly White-Agent said she had struggled to find appointments for her brother and 83-year-old stepfather, even after city and federal officials opened a mass-vaccination site to serve their largely Black neighborhood. She resorted to putting them on wait lists and hoping an extra slot opened up. “It’s like a mirage,” she said. Some of the leftover chasers are not yet eligible to sign up for appointments. Others are old enough or sick enough to qualify, but said that overloaded vaccination websites and endless hold lines convinced them to abandon the official channels and search for themselves. Gunnar Esiason, 29, has cystic fibrosis and said he was not about to wait until his New Hampshire vaccine appointment rolled around on April 21. So he started showing up at Walgreens pharmacies and state-run vaccination sites — wherever there was a whiff of an extra vaccine, until he got a tip that a Dartmouth medical center had a few extras. “I knew I was going to a lot of ‘No’s,’” he said. “All I needed was one ‘Yes.’” In Minnesota, Franke signed up for eight different vaccine lists managed by doctors, Walgreens, Walmart, even a state lottery, but said nobody called. Then last month, she got a tip that the mass-vaccination site at the convention center might have some extras. There were about 20 other people already milling around in the lobby when Franke arrived, she said, and a health worker quickly emerged to inform them there were no leftovers. But many in the crowd stuck around, and after a half-hour, the vaccination team allowed people 65 and older, teachers and emergency responders to get their shots. Franke lined up and said she cried with relief on the car ride home to the suburbs. Ashok Shah, 77, a retired internal-medicine physician in Poughkeepsie, New York, tried to sign up. But failed again and again. Shah said he and his 79-year-old wife spent weeks languishing on their county’s official vaccination lists. He would search fruitlessly for online appointments in the middle of the night, and put himself on informal wait lists kept by nearby pharmacies. When it became clear there would be little progress, “We had to go looking,” he said. In early February, with 6 inches of fresh snow on the ground and a nearly impassable mound plowed into the base of his driveway, he said a Rite Aid called with the news that they had one spare dose. “I said, I’ll take it,” said Shah, who got his second dose Tuesday. “Come rain, come shine, come snow, I’ll be there.” But leftovers are getting harder and harder to find. More people are looking, and the extras are dwindling as pharmacies and public-health agencies get better at matching each day’s available vials with their list of appointments. Vaccine teams in Fairfax County, Virginia, fill up individual syringes from a shared supply of vaccines to make sure they are not cracking open new vials at the end of the day. Several cities have created special leftover lists to offer doses to police officers, teachers or older people. Columbus, Ohio, said its “no waste” list of 250 people is full. At Discount Drug Mart, a chain of 76 pharmacies in Ohio, the vaccination teams add up their doses against no-shows throughout the day, and start reaching out early to the 25 people who are on their rolling standby lists. Rarely, someone waiting in the parking lot at 9 p.m. or calling on a whim may land a vaccine. “It’s a priority to never waste a dose,” said Jason Briscoe, the company’s director of pharmacy operations. Often, the hunt just amounts to days of frustration. Sara Stoltz has spent days driving around Dallas trying to get a leftover dose for her 64-year-old mother. They get turned away from pharmacies whose wait lists are already full at 200 people deep. They stop at every Walmart they can, only to learn that nobody missed an appointment. “I keep hearing rumors,” Stoltz said, with no dose behind them. “It’s like one of those urban myths.”

America’s most prized leftovers: COVID vaccines

On Sunday the advisory committee recommended states should put adults over 75 and “essential workers” next in line, as bus drivers, grocery store clerks and others are infected most often.

Moderna starts shipping its COVID-19 vaccine in U.S.

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Pressure grows on US companies to share Covid vaccine technology

US to miss Biden's July 4 vaccination goal

US prepares for a COVID-free future

America’s most prized leftovers: COVID vaccines

Moderna starts shipping its COVID-19 vaccine in U.S.