After several months of tense waiting, 117,000 doses of Pfizer, one of the most effective vaccines against coronavirus, promised under the Covax program, finally arrived in Ukraine. However, one aspect of vaccination with this drug has dropped out of sight of the authorities.
Our country has not purchased special syringes. This means that as much of the drug will go to the scrap as it would be enough for a complete vaccination of 10,000 people. And this is against the background of a total shortage of high-quality vaccines in Ukraine.
"Free" dose sows panic
Japan recently announced that it would have to throw away millions of doses of Pfizer simply because there were no "special" syringes in stock. And the point, in this case, is not in the miscalculation of the Japanese, but in the unexpected overflow of the vials by the manufacturer of the vaccine.
When using the drug, it turned out that many bottles contained not 5, but as many as 6, and in some places – seven doses. The "free dose" has proved to be a real boon at a time when the coronavirus vaccine is such a scarce commodity.
Later, Pfizer researchers and independent pharmacists from the US Food and Drug Administration confirmed that each vial contained enough vaccine for an additional injection. The US Food and Drug Administration (FDA) immediately advised hospitals to use these additional doses.
However, Pfizer said that it is impossible to mix "residual" doses from several vials. This means that the last portion of the vaccine must be withdrawn from the bottle "to the last drop."
Hence the problem. Pfizer does not provide syringes for "residual" doses. In addition, in order for the vaccine to last for the sixth dose, and it simply does not settle on the walls of the syringe, an ordinary needle does not fit. We have to think about special "economical" syringes with a reduced space between the needle and the piston when it is fully depressed.
Finding them in large quantities is not easy. Manufacturers did not anticipate that the demand for these syringes would increase, because until recently they were a niche product. This means that the reserves were insignificant. For example, in a batch of vaccination syringes prepared by the American manufacturer Becton Dickinson, only every seven syringes had a low dead space.
Now manufacturers of medical equipment around the world are massively reorienting themselves to new needs. The British company Vernacare said it plans to produce more than 1 billion special syringes per year, the South Korean company Poonglim – about 10 million syringes every month.
And what about Ukraine? Officials have not heard of a request for such syringes. Chief sanitary doctor of Ukraine Viktor Lyashko said that Ukraine will receive vaccines immediately along with needles, without specifying anything about syringes with "small dead space."
The international organization Crown Agents is providing syringes for mass vaccination instead of the State Enterprise "Medical Procurement," which the Ministry of Health was dissatisfied with. We contacted the company's representatives with a question about the procurement of syringes but did not receive an answer.
Proceeding from the complete absence of relevant data in the Ukrainian information space, there is a great risk that at the sixth doses they will simply be "drained" due to the short-sightedness of officials. Taking into account the fact that Ukraine is preparing to receive 117,000 doses of the vaccine, this is at least 19,500 lost doses, or 10,000 people who may be left without a vaccine with an efficiency of 96% (according to the epidemiological department of the Israeli Ministry of Health).
Although the Pfizer drug is free of charge within the framework of the Covax aid program for poor countries, such an irrational use of the drug against the background of numerous statements by the Ukrainian authorities about the shortage of vaccinations is unacceptable.
In theory, doctors could try to "get out" the last doses with one-millimeter syringes. Although at the same time there is a great risk that part of the drug will still go "for scrap" if doctors cannot collect the vaccine with pinpoint accuracy.
An ordinary syringe
In the world, one-millimeter syringes have already fallen into the scarce category. Some European hospitals even ask veterinary clinics about the availability of such syringes. As for Ukraine, the situation cannot be called critical due to the low rates of vaccination.
The delay in procurement can be explained by the fact that the officials did not have an understanding of how many and what syringes we needed. After all, some vaccines are not supplied in ampoules, but in packages ready for administration (syringe-tube). If in an ampoule, then an additional syringe is needed for its introduction. However, it has long been guaranteed that under the COVAX program, in the first stage of vaccination, we will receive 117,000 doses from Pfizer and from 2.2 to 3.7 million doses of AstraZeneca/Oxford vaccine. Both involve the use of disposable syringes.
In addition to the supply of vaccines and syringes to Ukraine, the planning of mass vaccination has other problems. Not only syringes are questionable, but also the availability of boxes for their disposal, as well as containers into which the vaccine is dosed. This is a global problem, which, unfortunately, Ukraine has not yet come up with. Another question is whether there will be enough refrigerators at the vaccination points, how reliable the storage process of vaccines that are demanding on temperature conditions will be (will there be temperature differences during a power outage).
But the authorities, apparently, will solve these problems as they come. And they will remember about the lost doses only when the Pfizer drug is no longer supplied to us free of charge, but for several billion hryvnias.