Wait lists, variants and other things you need to know about the COVID-19 vaccine 

February 02, 2021
a gloved hand holding a syringe with yellow liquid inside
Contrary to the buzz on the street there is no "leftover" vaccine at day's end. Photo by Diana Polekhina on Unsplash


For many, the word evokes nostalgic memories of what feels like a far-off time. A time when we would go out to a restaurant without wearing a mask – heck, who even owned a mask in 2019? – and come home with the last few bites of that precious meal. 

Today, leftovers are being spoken of again – and they are still as precious – only this time, it’s in reference to vaccine. Many people have reached out, wondering what happens to unused doses at vaccine clinics come the end of the day. 

Certainly, there are no-shows. Cancellations. One more dose in a vial than anticipated. 

And the public knows that once the Pfizer vaccine is thawed, the clock is ticking. 

Headshot of Scheurer 
Danielle Scheurer, M.D.

"At first that might have been the case,” said Danielle Scheurer, M.D., MUSC Health System chief quality officer. “But like anything you do over time, you get better, more efficient. So now we have a super-cold freezer at every one of our MUSC Health divisions. It takes no more than 30 seconds to reconstitute the dose, so we only draw up what is needed for the people who are actually sitting in front of us.”

So sadly, no, there is no wait list. No standby line. No leftovers. 

“People need to feel like this is a fair process,” she said. “So when they hear that one healthy 23-year-old snuck to the front of the line, it incenses them. Having the freezers at all of the divisions allows us not to waste a single dose – or administer one to somebody who shouldn’t be getting it now.”

With the vaccine landscape changing almost daily, each week we are checking in with Scheurer to ask her the most pertinent questions that are hanging in the balance.

Q. How do I know which brand of vaccine I got? 

A. Quite simply, MUSC only administers the Pfizer vaccine. Long-term care facilities and chain pharmacies like Walgreens and CVS are the only ones in South Carolina using the Moderna vaccine. Everything else is Pfizer (at least for now). 

Q. What have our two most recent quantities of vaccine been? Are we trending up?

A. Right now, we’re receiving about 80% of requested vaccine. (Note: Two weeks ago, MUSC got 30% of what it asked for.) Yes, we’ve lowered the number we’re requesting, but we’re still hoping for at least 12,000 doses a week. Last week, we got 9,000, and this week, we think we’re getting 10,000. Like I’ve said before, it’s a moving target. Typically, toward the end of the week, we get a tracking number that tells us how many cases we’re getting. It’s not an exact number, but it gives us a bit of a ball park. 

Q. Doses are one thing, but does MUSC have enough syringes and other necessary equipment?

A. There’s always one thing that is a pain in the neck, and right now, syringes-needles are the one. So it’s the new bottleneck. I think one of the reasons we’re in this situation is because even though we’ve found that there might be as much as 20% more doses in each shipment than we thought at the very beginning, the government is still giving the related equipment (gloves, syringes, etc.) based off the assumption of five doses per vial. 

Q. Has there been a change in who is allowed to administer the vaccine?

A. Yes. Actually, the state legislature has approved more types of health care providers who are able to administer now. Medical students and recently retired physicians and nurses who are in good standing can now help us to get these doses into the public’s arms. Currently, there is a proposal in front of the state legislature that will allow physician assistant students to get in and help as well. 

Q. How long after the second dose does it take for the vaccine to start fully working?

A. For the Pfizer vaccine, it’s seven days after the second dose. Moderna is 14. But that’s just when those companies decided to test the people involved in their trials. It could be sooner than that but just to be safe, after that amount of time you should be good to go.

Q. How long does the vaccine actually last?

A. Obviously we don’t know for certain, but there is some data from early clinical trials that those who received the vaccine had antibodies up to eight months out. Keep in mind, that’s just as far as we’ve gotten with being able to collect data. It could last way longer, but right now, that’s what we know. 

Q. Do women who are pregnant fall into Phase 1a?

A. Unfortunately not. They have no special designation. 

Q. What about transplant patients?

A. Same deal. All these subgroups who aren’t yet eligible make people very uncomfortable. Ideally, transplant patients would be vaccinated before they got the organ. To be honest, these patients should be way up on the prioritization list. 

Q. Can people get the second shot inside the 19-day window if their schedules necessitate?

A. I would definitely advise against that. This is a little unusual to have a booster so close after the initial dose, but we’re in a race against time here. The vaccine manufacturers want to help to speed the process up. So typically speaking, three weeks is super early for a second dose of a two-step vaccine. In other words, you’re better off going late (beyond the 23 days) than early, for lasting effect. 

Q. If I’m vaccinated and all my family members are vaccinated can we hang out together without masks?

A. For those in your close circle, you’re probably OK. The biggest question people are going to have now is can I expand my circle to a group of people that are vaccinated. And sure, if you’re talking about a group of people who are all vaccinated, we can conservatively say you are a little more protected. But the safe play is to still keep doing what we’ve been doing: social distancing and wearing masks. 

Q. What do people without computer access do if they need to sign up for the vaccine?

A. Starting this week, we will open a 24-hour call center. So people are welcome to call 843-876-7227 to schedule their appointments. Those with internet access can always go the route of muschealth.org/vaccine.

Q. We’ve talked about this before, but how worrisome is the new COVID-19 South African strain, or “variant”? And is Pfizer going to need a booster?

A. It’s a real concern. We know it’s more contagious. And there is evidence that the vaccine is less efficient against it. It’s kind of like the flu in the sense that the vaccines don’t tend to be an all or none proposition – there is a gradation of effect. Maybe you have symptoms, but they’re not as severe. Maybe your body doesn’t fend off the virus as quickly. You are almost always going to have some level of protection, having received the vaccine, but we just can’t really say how much. That said, right now there is no evidence that any of these variants render any of the vaccines completely ineffective.

Q How did we find out about these variants popping up in South Carolina?

A. The South Carolina Department of Health and Environmental Control, or SC DHEC, said that they are doing surveillance for variants every week. But my understanding is it’s a very small number of samples that they randomly screen. On top of that, they aren’t the only ones in the state running COVID samples anymore. So their screening doesn’t even draw from all of the cases in South Carolina. It’s just a small fraction. So for this South African variant to show up is a legitimate concern. 

**Have a question you'd like answered? Email it to donovanb@musc.edu with the subject line "Vaccine Q."