Canada Scrambling For Smaller Syringes Ahead of Expected Pfizer Vaccine Label Change

Pfizer and BioNTech will cut back on how many vials of COVID-19 vaccine they send Canada this year if the federal health regulator agrees to change the vaccine label to say every vial contains six doses instead of five.

Medical professionals in the United States were first to discover in December that they could get six doses from each vial by using special syringes that trap less vaccine around the needle after an injection.

Initially heralded as a way to stretch the precious vaccine even further, the company stepped in to note its contracts are for doses, not vials: If a recipient can get six doses instead of five, then Pfizer and BioNTech can ship fewer vials and still fulfil their contractual obligation.

Pfizer urged the United States and Europe to change the label information on the number of doses per vial, and both followed in early January. On Friday, Pfizer asked Canada to follow suit, and Health Canada’s vaccine management team is currently reviewing the request.

“The final decision on the label update will reside with Health Canada,” said Pfizer Canada spokeswoman Christina Antoniou.

If Canada agrees to the label change, Canada’s 40 million doses of Pfizer-BioNTech’s vaccine will be shipped in about 6.7 million vials. Antoniou said if Canada does not, then the existing deliveries will continue based on five doses per vial, for a total of eight million vials.

Health Canada spokesman Eric Morrissette said the department’s experts advised last month that where a sixth dose can be obtained from a single vial, it can be used. He said a decision on the request to formally change the label will be made “in due course.”

There has been some success at extracting extra doses in Canada so far. Saskatchewan reports receiving 22,425 doses of Pfizer’s and 10,300 doses of Moderna’s vaccine, for a total of 32,725. But it has injected 34,080 doses. The government attributed that to being able to get more doses out of each vial than expected.

But European health officials have complained that a shortage of the special syringes needed is making it hard to get six doses out of each vial.

If Canada agrees to the change but can’t get the six doses out of every single vial, its goal to vaccinate 20 million people with Pfizer’s 40 million doses will be impossible to meet.

Morrissette said the extra dose requires the use of a low-dead volume syringe, which leaves less room for the vaccine to get trapped in the needle and syringe after the plunger is pushed in all the way.

Those syringes are not as common as the three- and five-millilitre syringes mostly used in Canada’s vaccine campaign now, and the smaller ones have become the latest hot commodity of COVID-19.

Public Services and Procurement Canada tendered contracts last year for 145 million syringes, 95 million of which are of the three- or five-millilitre varieties.

There are 50 million one-millilitre syringes on order, including 37.5 million low-dead-volume versions. Morrissette said the first of the low-dead-volume syringes are supposed to arrive in Canada next week.

The department did not say how many syringes each arrived in Canada. A tender for the 1 ml syringe issued in October has set a deadline for the first 15 million to be delivered by the end of this month and the rest by the end of March.

But any information has yet to be made public, including who the supplier is, how much it is worth, or when the supply will be delivered.

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