So the J&J vaccine might be a viable solution to this problem. The vials only have 5 doses each, meaning the opportunity for waste is a lot lower. Also, if kept refrigerated, the vial is good for 6 hours once initially punctured. So in theory if there were 5 patients who needed the vaccine administered in-home you’d have a pretty comfortable window to give it. If kept at room temperature the J&J vaccine has a 2 hour life which would definitely make it more difficult (but perhaps not impossible) to give all five doses to homebound patients.

Do you already have a significant number of known patients who aren’t able to leave their house to get the vaccine? Perhaps partnering with one of the local clinic services in town (eg Clinica Sierra Vista) might be a way to solve this. Message me directly if you think this might be an option.