Confusion over doses in Pfizer vaccine vials
OTTAWA • Canada could see fewer doses of Pfizer’s COVID-19 vaccine depending on a regulatory rule around just how many doses each vial of the vaccine contains.
Pfizer was set to deliver four million doses of the vaccine to Canada by March 31, and had pledged to retain that target even after recent slow downs saw the company slash deliveries while it upgraded its plant in Belgium, with zero doses arriving in Canada this week.
Provinces said Thursday morning they were warned by the federal government that number could fall to 3.5 million.
Maj.-gen. Dany Fortin, who is overseeing the rollout, insisted the company was still on target to meet that goal. He said there was now a discussion over how many doses were contained in each vial.
The company’s initial estimate — and its Health Canada approval — said each vial of the vaccine contained five doses, but the company now believes it contains six.
“Pfizer has assured us that Canada will receive four million doses by the end of March, full stop,” he said. “We are doing the math with five doses per vial. Pfizer is doing the math with six doses per vial. That decision has not been made yet.”
He said the 3.5-million dose figure provided to provinces was based on a conservative estimate calculating only five doses per vial and was given to the provinces for planning purposes. He said Pfizer had pledged to meet the four-million dose target even if the five doses per vial regulation held.
A Health Canada spokesperson confirmed Pfizer had asked for approval to relabel their vials to indicate there were now six doses, but there was no timeline on that decision.
“This submission is under review, and a decision will be made based on the data that has been provided in due course,” said spokesperson Eric Morrissette.
Morrissette said it was about reviewing the evidence from Pfizer, but the sixth dose had been extracted from vials in the rollout so far.
“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vials are required to include a certain amount of overfill to ensure that the appropriate number of doses can be withdrawn, and Health Canada has acknowledged that an extra dose could sometimes be extracted from vials.”
The company has received approval from American and European regulators to relabel its vials to indicate there were six doses inside.
Extracting more doses requires those administering the shots to use low dead space syringes, which reduce the room between the plunger and the needle so vaccines aren’t wasted.
The government has ordered 37.5 million of these syringes with two million of them set to arrive next week. An official with the procurement department said that order should be fully delivered by mid-april.
Moderna, the other approved vaccine in Canada, is still targeted to meet its goal of two million doses before the end of March.
Pfizer has been reducing shipments to Canada for two weeks as it upgrades its factory to ultimately produce more vaccines. The company shipped zero doses this week and will ship just 79,000 next week, followed by 70,000 in the second week of February. Canada was originally supposed to get 367,000 doses of Pfizer’s vaccine each week in February.
Pfizer initially said the factory upgrades would lead to a 50 per cent reduction, but the cuts have been much deeper.
Fortin said starting the week of Feb. 15 doses will ramp up with 335,000 doses expected that week and 395,000 doses in the last week of February. He said April is when the rollout will fully ramp up.
“This is a bump in the road, not insignificant, but we have to look at the long game,” he said. “We’re expecting 20 million doses of authorized vaccines to be available starting in April for the April to June time frame.”
Those include doses from Pfizer and Moderna, but more doses could be available if vaccines from Astrazeneca as well as Johnson & Johnson are approved.
The differing numbers left provincial governments confused, angry and exasperated Thursday.
“We can’t vaccinate people when we aren’t getting vaccines and when we aren’t getting accurate information from the federal government,” said Saskatchewan Premier Scott Moe.
A spokesman for Moe’s government said Saskatchewan has been able to get six doses from about half its vials of Pfizer vaccine so far, but it is not consistent.
“Due to this inconsistency, health officials view the ability to draw additional vaccine as a surplus benefit, not a benchmark to plan for,” said communications director Jim Billington.
Alberta’s Health Minister Tyler Shandro said the cuts were unacceptable and made it difficult for the province to plan its expanded vaccine campaign.
“For the third time this month, the federal government has notified us through bureaucratic channels that Alberta’s Pfizer vaccine allocation will be slashed yet again,” he said.
Shandro said in addition to being unexpected the reductions had consistently been worse than expected.
“The federal government is failing Canadians. This is a grim situation that seems to be getting worse every week. We know that life for Canadians will not begin returning to something resembling normal until our most vulnerable are immunized.”