Health Canada says Pfizer’s vaccine vials can be stretched to 6 doses

After an independent regulatory review, Health Canada has agreed with a request from Pfizer to recognize that each vial of the company’s vaccine includes six doses, not five.

The labelling change means that more shots can be squeezed out of each vial — and the company can ship fewer vials and still meet its contractual obligations to send a certain number of doses to its customers.

While some provinces — notably Saskatchewan and Quebec — have succeeded in extracting more from each vial, Health Canada had been saying up to now that the vials are only good for five doses.

Health Canada and other international regulators require vials to include a certain amount of overfill to ensure there is sufficient vaccine in each vial to yield the expected doses.

In its review, the regulator concluded that six full doses can be obtained consistently from the Pfizer vials through the use of low-dead-volume syringes, which allow the user to push virtually all fluid out of the syringe chamber. The government has scrambled to order large numbers of these syringes in recent weeks.

“In order to extract a sixth dose reliably and consistently, a specialized syringe should be used,” said Dr. Supriya Sharma, Health Canada’s chief medical adviser.

Public Services and Procurement Minister Anita Anand has said the federal government has ordered 64 million specialized syringes. One million were set to be delivered this week.

Change follows similar move in U.S. and Europe

Health Canada’s move follows a similar label change by the European Medicines Agency and the U.S. Food and Drug Administration (FDA) late last year.

While the label change comes into effect immediately, shipments to Canada for this week that have already begun are calculated at five doses per vial. Canada is expected to take delivery of 70,000 doses this week.

The new designation means fewer vials could be shipped in the weeks ahead while the number of extractable doses remains the same, as long as provinces are properly equipped with the syringes. Under its contract, Canada has ordered a certain number of doses from Pfizer — not vials.

“While there is a change in doses contained in each vial, the country’s overall allotment from the manufacturer remains the same,” said Maj.-Gen Dany Fortin, the military commander leading vaccine logistics at the Public Health Agency of Canada.

“The distribution process though will not change, and vaccines will continue to be allocated on the basis of an equitable allocation framework that has been agreed to by all jurisdictions moving forward.”

After weeks of smaller-than-expected shipments because of production delays, Fortin said Pfizer is prepared to significantly ramp up shipments in coming weeks as it looks to meet its promised goal of delivering four million doses by the end of March.

“Starting on the 15th, we are expecting hundreds of thousands more doses each week — and that’s just from Pfizer,” Prime Minister Justin Trudeau said. “Moving forward, we’ll get more doses and get them even faster.”

Fortin said Canada is on track to receive and distribute approximately 400,000 doses next week and 475,000 doses in the last week of February — significantly more than what the company has delivered in recent weeks.

As part of this label change authorization, Pfizer is required to provide continued educational support to vaccine administration sites in Canada and to help the government to acquire more of the specialized syringes, if required.

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