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Pfizer pushes Health Canada to stretch vaccine doses per vial as demand mounts

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Pfizer is asking Health Canada to consider boosting the number of doses it extracts from each vial of the coronavirus vaccine from five to six, a move that would allow the company to send fewer vials to Canada while still meeting its contractual obligations to send 40 million doses to Canadians.

“We will fulfill our supply commitments in line with our existing agreement – which are based on delivery of doses, not vials – and in accordance with Health Canada approved labeling,” Christina Antoniou, director of corporate affairs for Pfizer Canada, confirmed in an emailed statement.

The request comes amid a fervent demand for the coronavirus vaccine around the world, a hunt that has become heightened as vaccine nationalism has started to take root in many countries.

Read more: EU dispute with AstraZeneca over COVID-19 vaccine commitments won’t affect Canada: Trudeau

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While standard syringes can only consistently draw five doses out of the vials, there is some excess that remains after that point. If the medical professional administering the vaccine uses a special kind of syringe, Pfizer says it’s possible to “extract 6 doses from a single vial.”

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That special syringe or needle is called a low dead-volume needle. While Canada has ordered over 145 million syringes to date as a part of its procurement efforts, just 37.5 million of those syringes are low dead-volume.

“In a situation of limited vaccine supply amidst a public health crisis, our intent with this label change is to provide clarity to healthcare providers, minimize vaccine wastage, and enable the most efficient use of the vaccine,” Antoniou said.

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In response to further questions from Global News, Antoniou said the company does “not have information that shows how often six doses are extracted from vials.”

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A full dose of the vaccine is 0.3 millilitres. Without a low dead-volume syringe, “there may not be sufficient volume” to extract that full dose from the vial, Antoniou said.

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If Health Canada decides to grant Pfizer’s request to increase the label on each vial from five doses to six, Canada will need to ensure it has enough of the right kind of needle to extract that final dose from every vial delivered. That’s because Pfizer will recalculate the number of vials it ships to Canada to account for each containing an additional dose of Canada’s promised 40 million.

In a statement emailed to Global News, a spokesperson at Health Canada confirmed that Pfizer has made a submission to update its vaccine’s labeling to reflect the availability of an additional dose in the vials.

“This submission is under review, and a decision will be made based on the data that has been provided in due course,” the statement said.

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Health Canada also said Public Services and Procurement Canada has pre-ordered 37.5 million
“low dead volume syringes.”

“The first deliveries of those syringes are expected to arrive in Canada next week,” the statement read.

The agency said the vaccine “remains unchanged,” adding that there would be “no change to the volume of vaccine in each vial.”

“Vaccine vials are required to include a certain amount of overfill to ensure that the appropriate number of doses can be withdrawn, and Health Canada had acknowledged that an extra dose could sometimes be extracted from vials,” the email said.

Pfizer has also confirmed that the final dose cannot be obtained by pooling the remnants of multiple vials together if they fall short of the 0.3-millilitre requirement, making the proper syringe even more essential in ensuring Canada makes use of all the doses.

Meanwhile, the United States has already announced its intention to squeeze a sixth dose out of its vials of the Pfizer vaccine – raising questions about the impact of Canada following suit.

Read more: Canada not looking at suing Pfizer over COVID-19 vaccine delay, minister says

When pressed on whether Health Canada’s decision regarding the doses could impact Canada’s vaccine rollout, Indigenous Services Minister Marc Miller said on Wednesday that he remains confident that the company will deliver on its promises.

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“I didn’t quite get that it was an effort to reduce the number of vials, but really to increase the efficacy of what you can get out of them,” Miller said.

“I think all communities expect Pfizer to fully fulfil their contractual obligations. Our… objective is to get as many doses, as quickly as possible into the arms of Canadians, particularly those that are most vulnerable.”

Canada has pledged to provide a vaccine to all Canadians who would like one by September — a commitment Prime Minister Justin Trudeau said has not changed, despite some delivery delays that have slowed the Pfizer vaccine’s arrival and the hints of increasing vaccine nationalism.

“Over the past few weeks, I’ve spoken with executives at both Pfizer and Moderna who have assured me that we are very much continuing to be on track for receiving our full doses of vaccines in the timelines provided — that is, a full six million doses from Pfizer and Moderna by the end of Q1, the end of March,” Trudeau said, speaking from the front steps of Rideau Cottage on Tuesday.

“We are extremely confident we will be able to have everyone vaccinated who wants it in Canada by September 2021.”