More doses per vial?
Changes could mean gradual increase in vaccine supply for Hampton Roads
In the months since coronavirus vaccines were first released, officials have learned several lessons about the best ways to administer them.
But another development centers around how many doses officials can get out of each glass vial. Numerous doses are stored in each vial, and they are transported around the country in large batches.
Moderna and Pfizer, however, have discovered they can eke out more doses of their vaccines in each glass than they originally thought. That could translate into the public getting vaccinated faster.
Federal officials gave approval to Pfizer in January to go from five doses per vial to six. Moderna has asked the FDA to go from 10 doses to 14 or 15, and is awaiting the OK. (The new, single-shot Johnson & Johnson vaccine contains five doses.)
Moderna supplies about half of the nation’s vaccine stock, the New York Times reported in mid-February, meaning a 14-dose vial “could increase the nation’s vaccine supply by as much as 20 percent at a time when governors are clamoring for more vaccine and more contagious variants of the coronavirus are believed to be spreading quickly.”
Could it speed things up in Virginia, at the same time the state is getting 69,000 initial doses of the new, single-shot Johnson & Johnson vaccine?
Sort of. A bit. It’s complicated. More than 2.5 million vaccine doses have been administered in the commonwealth — not count
ing those given federally, such as through the military. The Pfizer change happened after pharmacists discovered a small amount left in each vial amounted to a full dose. A tray of Pfizer vials now includes 1,170 doses, up from 975, according to the Virginia Department of Health.
Naturally, more doses means more people getting vaccinated. But the amount health providers are able to get out of a vial depends on the equipment they use.
Pfizer didn’t actually add any product into its vials, Cindy Williams, vice president of pharmacy at Riverside Health System in Newport News, said through a spokesperson.
“Based on the dead space volume in the syringe, we have gotten 6 doses per vial since the product became available in December,” she wrote in an email. “The change better reflects the actual doses available.”
The ability to get all six has depended on the type of syringes sent with the vaccine, Chesapeake Regional Healthcare spokesperson Tricia Hardy said.
To squeeze out all six requires using special syringes that are in short supply. President Joe Biden’s administration has said he plans to use the Defense Production Act to procure more.
“As a result, the sixth dose is often discarded, trapped in the small dead space in regular syringes, where the syringe’s stopper cannot reach it to plunge into a human arm,” the Washington Post reported.
Considering the demand for syringes and needles globally, Sentara spokesperson Kelly Kennedy said, “we can’t stock up on just one type.”
On the flip side, Sentara and other local systems have been able to sometimes extract more than 10 doses from Moderna even while changes to the official instructions are pending — up to 11 or 12 given the proper equipment.
If the FDA does let Moderna add more into its vials, Riverside’s Williams expects “the resulting increase in manufacturing capacity due to the change will increase vaccines available in the area.”