While poor countries struggle to find vaccines, places that bought too many are scrambling to get rid of doses about to expire

mguenot@businessinsider.com (Marianne Guenot) 

Pfizer BioNTech's COVID-19 vaccine on Dec 17, 2020 in Victorville, California. Irfan Khan / Los Angeles Times via Getty Images

Countries including Israel, Bulgaria, and parts of the US have more vaccines than they can use.

They are trying to sell on hundreds of thousands of doses before their expiry dates arrive.

It is a stark illustration of global vaccine inequality: other nations are desperate for shots.

Last week, Israel was on the cusp of throwing out close to one million doses of unused Pfizer coronavirus vaccine. Domestic demand for the shots was too low, and the shots were due to expire at the end of July.

Talks with the Palestinian authority and other countries to take the shots fell through one after the other.

But in the nick of time, Israel found a taker. On Tuesday, it announced that South Korea would take 700,000 doses.

As part of this last-minute deal, South Korea agreed to send back an identical number of doses when it gets its next batch of vaccines from Pfizer in September and October, Reuters reported.

Excess vaccine supply is a new problem for the rich countries that monopolized global supplies.

It coexists uncomfortably with the desperation elsewhere from poorer nations where campaigns have barely begun.

According to Our World in Data fewer than 1% of people in low-income countries have been given even a single dose. Papua New Guinea and Chad have both administered doses to fewer than 0.1% of their populations, per figures compiled by The New York Times.

US at a vaccine 'saturation point'

Some US states are facing much the same problem as Israel.

"If you look at the US, we're clearly approaching saturation in terms of people's willingness to be vaccinated," Hani Mahmassani, Director of the Transportation Center at Northwestern University, told Insider.

Vaccines are sitting unused in states where uptake is low. Oklahoma, Alabama, Utah, Delaware, and New Hampshire have stopped asking the government for new doses of vaccine as they work through their stockpiles, the Associated Press reported.

In June, Tennessee and North Carolina gave millions of doses back to the federal government due to low demand, the AP said. Mississippi returned more than 870,000 doses, and donated 32,400 to both Maine and Rhode Island.

"In Mississippi, if people don't understand how important it is to keep alive, we want to protect other Americans," said Mississippi State Health Officer Thomas Dobbs.

 A sign encouraging vaccination in Birmingham, Alabama, on June 30, 2021 Elijah Nouvelage/AFP; Getty Images

Even countries with low vaccination rates have stockpile problems

Romania, too, has stockpile issues. Even though its rate of vaccination is low, with 23% fully vaccinated, 43,000 of its AstraZeneca shots expired last month.

To get rid of its stockpile, the country announced it would sell about 1.2 million doses of vaccine to Denmark and another million doses to Ireland.

Bulgaria is also looking to donate its excess doses of vaccines. The country received 4.6 million doses but has used only 1.8 million. That is in spite of only about 12% of its population being vaccinated.

Uptake in both countries has been low, in part because of logistical issues but also because of high levels of vaccine hesitancy, according to local news reports.

The same has been seen in some African countries. About 1.25 million AstraZeneca doses, spread between 18 African nations, will expire unless they are used by the end of August, according to the World Health Organization (WHO).

A violinist performs during Romania's "vaccination marathon" at the National Library in Bucharest, Romania, May 9. Cristian Cristel/Xinhua; Getty Images

One solution: extend the expiry date

According to a blog post from GAVI, a public-private organization that helps distribute vaccines to poorer countries, vaccine manufacturers were "extremely cautious" when they set the expiry dates for the vaccines.

Most vaccines expire around 3 years after they are produced, but the shelf life for COVID-19 vaccines is a lot shorter: six months for the Pfizer, Moderna, and AstraZeneca's vaccines, three months for the Johnson & Johnson vaccine.

Last month, Johnson & Johnson added an extra six weeks to the shelf life of millions of unused doses in the US that were set to expire on June 10.

Canada also approved extending the shelf life of two lots of AstraZeneca vaccine by 30 days in May.

Pfizer, however, told Israel that it could not ensure that its doses would be safe beyond the current expiry date, according to the Times of Israel.