An unintended consequence of COVID-19 safety procedures has been a surge in trash, from face masks to gloves to, now, the discarded syringes and needles from COVID-19 vaccines. If laid end to end, the needles from the number of vaccine doses needed to inoculate the entire U.S. population—about 660 million—would create enough waste to wrap around the Earth 1.8 times, according to OnSite Waste Technologies, a medical waste disposal company. It’s certainly worthwhile trash to create, but with the vaccine rollout in full effect, and President Joe Biden’s goal to deliver 100 million vaccinations in his first 100 days underway, companies that manage medical waste are having to handle this uptick.
Each needle, syringe, vial, and packaging joins the waste from approximately 198 million doses of influenza vaccine the CDC produced for this season, says Jim Anderson, vice president of product management and innovation at medical waste disposal company Stericycle, in a statement. “Fortunately, this waste isn’t being generated all at once, but rather in phases as the vaccine is rolled out across priority groups,” he notes. “Additionally, while the industry may see an influx of sharps waste, that volume is being offset by declines in waste volume in other areas such as elective procedures.” Medical waste such as masks or needles isn’t something people thought about before 2020, says Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, whose work focuses on pandemic preparedness. But during the COVID-19 pandemic, this issue has become more visible. “There’s so much personal protective equipment being worn by the general public in terms of masks that people are worrying about it and [wondering] are those masks being disposed of appropriately?” he says. And regarding biohazard waste “in terms of the needles and syringes,” he adds, “there clearly is going to be an uptick in that type of waste.” At least we know how to dispose of needles, he adds, especially considering how many children get vaccinated each year. So what will happen to all the added waste from COVID-19 vaccines? The normal medical waste disposal process goes like this: Hazardous or infectious medical waste gets put in sharps containers and picked up from healthcare facilities and transported to processing centers to be autoclaved, meaning it’s sanitized with high-pressure steam in an autoclave machine, before it’s sent to landfill alongside other trash. Along with the needles and syringes, glass vaccine vials go into sharps containers, as they can’t be recycled. Other waste, such as the box that held the vial trays and general packing materials, may be sent back to the manufacturer (Pfizer actually requires this to help “fulfill its commitment to reusable resources”). When waste isn’t picked up by a disposal company right away, it has to be stored on-site. That means the added volume of all this waste could still pose challenges for small healthcare facilities, which, unlike large hospitals, may not have space. For those offices, OnSite Waste Technologies says it has a solution with its TE-5000 machine. That machine can get filled up with needles just like a sharps box, and then it heats up those needles for 90 minutes at 380 degrees, sterilizing and also melting down the items to reduce their total volume. “When we’re done processing it, it goes from a full container down to a very small brick of plastic and needles that are encapsulated,” says OnSite CEO Brad Barnes. “We’re reducing the wasteload before it leaves the facility, and when we’re done with our technology, that percent that is left is now municipal waste and can be thrown directly into the trash.” Barnes says the machine can reduce waste volume by 80%, which means less volume in landfills and a smaller carbon footprint because of fewer truck trips to haul away the waste. OnSite, a Newport Beach, California-based startup, secured $3.5 million in venture capital funding in October, bringing its total funding to $8.5 million. Barnes is realistic that his device won’t disrupt the entire medical waste market, at least not for hospitals. But for clinics and smaller facilities, he thinks a new way of disposing of this waste could make a difference, especially amid the pandemic. Eventually, OnSite hopes to be able to recycle that brick of plastic that comes out of its machines. As for the other pounds of COVID-19 vaccine discards that won’t be melted down into such bricks, they may just end up in landfills. One day, Adalja says, we may get our vaccines through patches—which could eliminate the medical waste that comes with injections, according to the CDC foundation—but those haven’t yet been approved for commercial use. In the meantime, the COVID-19 vaccines are injectables, and that means needles, syringes, and vials will pile up—but for now, it’s worth it. “The benefit of the vaccine outweighs any concerns about that type of medical waste that’s being generated,” Adalja says.