On December 29 last year, Hasan Gokal, the medical director of the COVID-19 response team in Harris County, Texas (which includes Houston, the fourth-largest city in the United States by population), was supervising the administration of the Moderna vaccine, mostly to emergency workers. The vaccine comes in vials containing 11 doses. A vial, once opened, expires in six hours and unused vaccines must then be thrown away.

On that December day, a patient arrived just before closing time, so a nurse had to open a new vial, leaving Gokal with 10 doses. He offered them to the health-care workers and to two police officers still on the site, but they had either been vaccinated, or declined. He called a colleague whose parents and in-laws were eligible — anyone over 65 or with a medical condition that increases the risk from the coronavirus could then be vaccinated — but they weren’t available.

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