SA might be over-counting its Pfizer Covid-19 vaccine doses

Fulcrum29

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If wealthy countries can’t get these low dead volume syringes – what about us?

Tender lovin’​

According to Business for South Africa (B4SA), part of the state tender for Covid-19 vaccine syringes (for the 1ml and 0.5ml syringes) was awarded “about four weeks ago”. According to B4SA, “The 0.3ml syringe contract has not yet been awarded, and is currently outstanding due to these syringes awaiting SABS approval … the Pfizer vaccine requires a 0.3ml syringe to optimise its administration.”

Yeah... tenders where there shouldn't be any.

I won't be surprised whether this is the reason why we are widening the vaccination gap between dose one and two to, well, nobody knows yet.
 

upup

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Yeah... tenders where there shouldn't be any.

I won't be surprised whether this is the reason why we are widening the vaccination gap between dose one and two to, well, nobody knows yet.
What should the time be
 

Fulcrum29

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What should the time be

It is too hard to say, the recommendation by the CDC is 3 weeks, but pending on the active coronavirus variant it can be stretched up to 12 weeks. The UK is currently at 8 weeks to best combat the Delta variant.
 

Botha22

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Not the only country struggling with Pfizer's attempt to squeeze every last dollar out of this pandemic:
 

Botha22

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How and what are they attempting?
Nothing wrong with them making a profit, they are not a charity. My comment was based on this and other articles and the fact that the other vaccines do not seem to have this counting controversy.

From the article:
Drug companies typically add a small amount of drug or vaccines in vials of injectable pharmaceuticals to ensure that medical staff will have enough for the full dose. Doses may bubble up when they are shaken, and small amounts are typically trapped in needles and syringes. Pfizer requested and won an amendment to its Food and Drug Administration authorization to count that overfill as an additional (6th dose, although you need a special / niche syringe (low dead volume syringe) to get that 6th dose.

Other countries (Japan, European countries etc) have had the same problem with this 6th dose, so the snide remarks about South Africans not being able to count are unwarranted.

"USA and Pfizer finalized a deal Friday that will allow the government to track which shipments are accompanied by low dead space syringes and which are not, according to an individual close to the negotiations who spoke on the condition of anonymity to discuss the details.
Vials accompanied by regular syringes will be counted as five doses against Pfizer’s contract for 200 million shots, and those accompanied by special syringes will count as six shots toward contract fulfillment."


The ideal way to structure the SA & Pfizer contract would be 5 doses per vial or word it as per the above USA contract, as we do not seem to have the special syringes.
 

Fulcrum29

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Nothing wrong with them making a profit, they are not a charity. My comment was based on this and other articles and the fact that the other vaccines do not seem to have this counting controversy.

From the article:
Drug companies typically add a small amount of drug or vaccines in vials of injectable pharmaceuticals to ensure that medical staff will have enough for the full dose. Doses may bubble up when they are shaken, and small amounts are typically trapped in needles and syringes. Pfizer requested and won an amendment to its Food and Drug Administration authorization to count that overfill as an additional (6th dose, although you need a special / niche syringe (low dead volume syringe) to get that 6th dose.

Other countries (Japan, European countries etc) have had the same problem with this 6th dose, so the snide remarks about South Africans not being able to count are unwarranted.

"USA and Pfizer finalized a deal Friday that will allow the government to track which shipments are accompanied by low dead space syringes and which are not, according to an individual close to the negotiations who spoke on the condition of anonymity to discuss the details.
Vials accompanied by regular syringes will be counted as five doses against Pfizer’s contract for 200 million shots, and those accompanied by special syringes will count as six shots toward contract fulfillment."


The ideal way to structure the SA & Pfizer contract would be 5 doses per vial or word it as per the above USA contract, as we do not seem to have the special syringes.

You need to take circumstance under consideration,


Supply Focus​

Low-dead space syringes have gained the spotlight against a backdrop of shortages of Covid-19 vaccines, a key constraint throughout the U.S. immunization push to date.

“The biggest challenge I’m hearing from states right now is simply a lack of supply,” said Representative Diana DeGette, a Colorado Democrat who chairs the House Energy and Commerce Committee’s oversight panel, which held a hearing last week with state officials on boosting vaccine distribution. “They stand ready to vaccinate many more Americans if we just get them the doses they need.”

Andy Slavitt, a senior adviser to the White House’s Covid-19 effort, said at a briefing last week that about 80% of Pfizer kits contain low-dead space syringes, while the rest contain other syringe types that could be used to extract the sixth dose. Asked for comment on Monday, the White House referred to Slavitt’s remarks.

In reality, it’s unclear just how available those syringes are.

...

Government Kits​

About 85% of syringes in government-provided kits are low-dead space ones, said Mark Jarrett, chief quality officer for Northwell Health. The remainder are larger syringes with longer needles to vaccinate patients who are larger physicially, he said.


Yet Northwell is currently focused on vaccinating the elderly, who generally don’t require the larger syringes. Jarrett said he would prefer to have kits fully composed of low-dead space syringes, to extract more doses. Northwell is extracting six doses of 10-15% of vials, he said.

“Right now we get low-dead space syringes from the federal government, but not enough for everybody,” Jarrett said. “We have ordered the low volume ones but everyone else is ordering them at the same time. There is a national shortage.”

Most suppliers are limiting providers to an allocation based on their purchasing patterns, meaning securing extra supply of low-dead space syringes for Covid-19 vaccination efforts can be difficult, Premier’s Daley said.

...

Becton Dickinson and Co., the world’s largest needle and syringe manufacturer, contracted with the U.S. government to deliver 286 million needles and syringes for the vaccination push, including 40 million low-dead space syringes. Yet because demand for the devices has historically been much lower, “we have limited production capacity,” said Troy Kirkpatrick, senior director of public relations.

The vaccine makers and producers don't produce the syringes, but the OP article states,

In the US, unlike South Africa, Pfizer ships its vaccines with appropriate needles and syringes.

which is not how it works. Becton Dickinson did participate in the tender process,

Becton Dickinson confirmed with GroundUp that it was one of the successful bidders in this contract, and that this order includes a provision for low dead volume syringes.

GroundUp has been trying to receive an answer from the health department since the beginning of June on the state of low dead volume syringes and needles. Repeated inquiries were made to Popo Maja, Head Of Communications at the Department of Health, as well as to Khutso Rabothatha, spokesperson for the Deputy Minister Dr Joe Phaahla. We have received no response. The National Treasury’s broken eTender portal does not show any information on the contract award for this tender, nor does the health department’s official website.

considering the circumstance, SABS approval should be expedited, but I have an idea that the department is sitting on these tenders,

The list of bidders for what appears to be the contract for syringes can be found here, and the special condition of the contract here. No mention of low dead volume syringes is made in either document, and no other document is apparently available on this tender or its award.

who is really squeezing who here?
 

krycor

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If only someone mentioned this months ago.. who saw this coming.. oh that’s right, I mentioned this a few months ago not because I was psychic or in the industry but because I watch the news from the UK & US.

Anyways.. more reason why the Pfizer solution is not really a solution for SA. I do wonder who will pay for the “lost” dose.
 

MeestaR

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A tender for every small thing?? Information is critical, so some people chose to ignore it (I dare not say it, you get the point) and money's a wastin...

Before we know it, people wil tender for the smallest thing, like every single piece of cheese.
 

Swa

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This isn't the biggest issue. Who's to say every syringe is filled to the correct mark. Also I've seen it countless times where syringes are overfilled and then the excess is discarded to get rid of any air. Don't know if it makes a difference but somehow I doubt a bit of "dead space" is going to give you that extra dose.

Brings up an interesting issue. Why are they using such concentrated doses and not more diluted ones where it's easier to measure the exact volume?
 

C4Cat

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Lots of assumptions in this article but it is a concern
Yeah... tenders where there shouldn't be any.
What's the alternative?
A tender for every small thing?? Information is critical, so some people chose to ignore it (I dare not say it, you get the point) and money's a wastin...

Before we know it, people wil tender for the smallest thing, like every single piece of cheese.
You think a contract to supply many millions of quality syringes is a small thing?
 

Gaz{M}

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The article doesn't say if we do or don't have the correct syringes. They are still investigating. Surely a big company like Discovery would have made a stink if it was only getting 5 out of a vial?
 
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