Five doses or six? Canada’s short-term vaccination goals dependent on how far we can stretch each vial

Health Canada weighing request from Pfizer to get six doses out of each vial amid production slowdown

Short on time? Here’s what you need to know:
-Health Canada is exploring whether six doses can be drawn from each vial of the Pfizer vaccine, as suggested by the manufacturer amid a stall in production overseas
-Should Canada opt to draw six doses instead of the standard five, that would mean Pfizer could deliver on the 4 million doses it is contracted to provide by the end of March
-Officials continue to explore other vaccine suppliers

Despite a production shortfall of the Pfizer vaccine, Canada is still expected to receive all doses it ordered by the spring. However, it might depend on how much can be squeezed out of each vial.

During a Thursday briefing with the media, the head of Canada’s vaccine rollout program, Major-General Dany Fortin, said, despite a significant delay in production, Canada will receive all four million doses of the Pfizer vaccine by the end of March as contracted. This comes despite an announcement from the drug maker to expect a fifty percent decline in global production, a decline that has prompted the manufacturer to suggest nations stretch out the supply they have and will soon receive. “We’re doing the math with five doses per vial,” said Maj.-Gen. Fortin. “Pfizer is doing the math with six doses per vial. That decision has not been made yet.”

The decision on whether healthcare workers in Canada can extract five or six doses out of each vial of the vaccine rests with Health Canada. The nation’s Deputy Chief Public Health Officer, Dr. Howard Njoo, explained that it is being explored whether six doses would be feasible. “The product monogram that has been approved from Health Canada states there are five doses available in a vial. What we also know is that, for vaccines in general, most of them are in liquid form,” said Njoo during Thursday’s briefing. “Therefore, it’s always a standard practice for a manufacturer to put a little bit more volume of liquid into a vial for a stated number of doses, recognizing that as you withdraw individual doses, there’s always going to be naturally some loss of some of the vaccine.”

“What Health Canada is going to be looking at, is there enough evidence information in the submission by Pfizer to indicate that you can, in a regular and consistent manner, draw out six doses from each vial in normal operating conditions,” he added.

As this decision is being weighed, provinces have been told to plan for 3.5 million doses coming to Canada by the end of March. Maj.-Gen. Fortin says this is purely for planning purposes, and that more than four million doses of the vaccine could be expected by then, as more manufacturers’ products become available.

While the production shortfall does make for a significant decline in the number of Canadians receiving their doses in the short-term, Fortin points out it is not a long-term problem. “This is a bump in the road, not insignificant, but we have to look at the long game,” he said. “We do have plans to scale-up significantly in the following months. And vaccines will start showing up in greater numbers as early as 15 February.” The federal government continues to negotiate supply details with other drug makers above and beyond Pfizer.

“I can tell you, from a numbers perspective, we expect to receive 6-million doses by the end this quarter, 20-million in the next one, and the remainder of the 80-million that was previously announced between the third and the fourth quarter, with the vast majority arriving in the summertime frame,” concluded Fortin. “We expect to have sufficient quantities by September to vaccinate every Canadian that wishes to get vaccinated.”