Published On: Wed, Jan 27th, 2021

States to get more syringes to extract bonus Pfizer COVID-19 vaccine dose


Vaccination centers across the country are expecting their first federal shipments this week of supplies designed to help them extract a sixth dose from vials of Pfizer’s COVID-19 vaccine, said state health officials. The specialized syringes are being sent a month after the FDA first gave the green light for health care providers to try to squeeze out the extra dose found in many vials.

Coronavirus vaccination site at NYCHA housing complex in Brooklyn
Registered Pharmacist Paula Agoglia fills a dead volume syringe with the COVID-19 vaccine at a pop-up vaccination site in William Reid Apartments in Brooklyn, New York City, U.S., January 23, 2021. 

POOL, via REUTERS


But the country’s supply of the syringes is scarce. To continue the new deliveries, the White House is pledging to use the Defense Production Act to ramp up manufacturing of these “low dead volume” or “low dead space” syringes, which minimize how much is wasted from the vials of vaccine. 

“Over the course of the pandemic, the Trump administration wielded the act’s powers to force suppliers to prioritize a variety of orders to combat the pandemic — including at least three contracts for syringes.”

“We’re going to be working across the government, with private industry, to ramp up production of vaccine and protective equipment — the syringes, the needles, the gloves, the swabs, and the masks — everything that’s needed to protect, test, vaccinate, and take care of our people,” President Biden said Tuesday, adding that the administration had “already identified suppliers” to move forward.

The Pfizer vaccine vials were originally billed as containing five doses, but providers quickly realized there was often enough leftover vaccine inside to safely extract a sixth dose if the low dead space syringes were used.

McKesson, the company tasked with distributing supplies for the nationwide vaccination effort, first disclosed last week it would start assembling “mega supply kits” sufficient to stretch each shipped tray of 975 Pfizer doses to administer 1,170 doses. 

In Maryland, health department spokesperson Charles Gischlar said authorities were told to expect kits with 1,000 low dead-space syringes and 200 regular syringes. Alabama Assistant Health Officer Dr. Karen Landers said officials there expected the kits to arrive with the Pfizer order the state placed last Friday.

“We have a mix of what they have available to send to us. The 1 cc syringes (the really skinny ones) that you see in the news have become short in supply, and we’ve had to move to larger syringes,” Tammie Smith, a spokesperson for Virginia’s health department, told CBS News.

“However, we are pulling extra doses out of some vials in every clinic that I know of,” added Smith.

But stepping up the nation’s supply of these syringes will pose a challenge for the Biden administration as it seeks to retool factories for a niche product that had previously been known mostly for its potential to cut down on waste of pricy medications or to curb blood-borne diseases like HIV among drug users who share needles.

“There was no discussion that low dead space was going to be a priority, or that it was going to be a need. You know, the vaccine companies weren’t talking about that,” Troy Kirkpatrick, spokesperson for syringe-maker BD, told CBS News.

As “the world’s largest producer of injection devices,” New Jersey-based BD says it has already supplied 150 million syringes to the U.S. vaccine campaign and has pledged a billion more for COVID-19 immunizations around the world through the end of the year, beyond the billions it routinely produces for health care providers.

But of the 286 million total syringes ordered by the U.S. government last year, just 40 million will be low dead space syringes. 

“We were pulling out all the stops and saying okay we can give you ‘x’-million of this type and ‘x’-million of this type, and it looked like we’re going to have 40 million dead space syringes available. And so that’s how that got thrown into the mix,” said Kirkpatrick.

In addition to its contract for BD’s syringes, the Trump administration also inked a deal last year to invest some $42 million to expand the company’s manufacturing lines in Nebraska. In exchange, the U.S. would have “priority access” to syringes from the new factory this summer.

Operation Warp Speed announced investments in several other suppliers of needles and syringes last year, though many do not manufacture low dead space syringes.

“Look, we stand ready to support the U.S. government in however they want to attack this. We just want to make sure everyone is grounded in the limitations of the production capacity,” said Kirkpatrick. 



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