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Clinica Sierra Vista began to administer Moderna COVID-19 vaccine to front-line staff on Dec. 23.

It's an inevitable situation for providers of the COVID-19 vaccine: leftover doses. 

In some cases, people scheduled for an appointment are no-shows. In others, there's a vial that isn't entirely empty at the end of the day, and throwing away even one dose of the vaccine is unfathomable.

"The motto is basically to make sure the vaccine goes into an arm rather than it going to waste," said Bakersfield pharmacist Ramy Ebeid, who works at Express Pharmacy on Calloway Drive. 

At Express, the pharmacy has a waiting list it uses, Ebeid said. Come closing time, if it looks like there's extra doses, pharmacy staff start making calls to see who can come get the injection. So far, Ebeid said, only two doses have been thrown away since the pharmacy first started offering it.

Bakersfield resident Christine Zimmerman said she and her husband waited outside the county's vaccine clinic at the Kern County Fairgrounds on Friday after a friend posted on Facebook that extra doses at the end of the day were being given to people who waited outside the gate.

Zimmerman's parents are both cancer patients and she wants to feel safer going into their home to take care of them, she said.

She and her husband were about 12th in line as the fairgrounds clinic was about to close shortly before 4 p.m. Sure enough, a public health worker came out to address the line.

There was one extra dose and priority would be given to those 65 and older, they were told. (Currently the vaccine is being offered only to health care workers and people 65 and over in Kern County.)

Alas, "some lucky soul got the shot," she said. 

Even if they had been offered a dose, Zimmerman said she and her husband — who are not in that age group — had previously decided they'd let anyone in that age group go before them.

But she hasn't ruled out going back. 

"I think any day we are done for the day with work and have time we will pop over," Zimmerman said.

Kern County Public Health Services spokeswoman Michelle Corson said "there have been some occasions where people were pulled in from outside the fairgrounds and given doses that were remaining after the appointments have been completed." But the county has established a waitlist of people to call if extra doses remain on a given day.

"We would discourage people from lining up outside of the fairgrounds," Corson said.

There is a deliberate approach taken by providers to ensure vaccine isn't wasted. Each vial of vaccine contains a certain number of doses — Pfizer's contains five to six while Moderna's contains 10. So clinics schedule vaccinations with the goal of not having any extra at the end of the day. But it just happens. 

Tim Calahan, a spokesman for Clinica Sierra Vista, said when someone is a no-show, their clinics will try to call a person who is scheduled on an upcoming day to come in early. But as a last resort, they will give it to whoever is nearby and willing to receive it, he said. 

That's how he got vaccinated, he said. While at a clinic in Fresno, there was an extra dose leftover of the Moderna vaccine, which spoils six hours after the vial is punctured. Calahan was the only one in the room who could take it.

"There’s no official guidance on how to do this. It’s kind of an awkward situation for providers," Calahan said.

But, he added, "we certainly don't want to waste it."

Why would anyone miss a vaccine appointment, considering how hard they are to get?

Calahan said in the scurry to get vaccinated, many people are signing up at multiple locations for appointments. So they may schedule an appointment at one clinic but get vaccinated elsewhere beforehand.

Bakersfield Heart Hospital CEO Michelle Oxford said by email that it is very strategic with its vaccinations to ensure none is wasted but there are some occasions when there's extra leftover.

"The few times we have had extra doses due to cancellations," she said, "we have solicited family members or drivers of those accompanying the 65 and older person getting vaccinated to ensure no vaccine is wasted."