A Pfizer vaccine vial now officially contains six doses instead of five -

Jae C. Hong / AP / SIPA

  • After the announcement of the European Medicines Agency on January 12, the Pfizer laboratory also made the decision to consider that a vial of its vaccine contained six and not five doses.

  • Due to this recalculation, Pfizer has announced that it plans to deliver fewer vials to Europe, for a similar number of doses.

  • Will Europe benefit from this sixth dose or is it a blow to vaccination?

Pfizer announced it this Friday.

The pharmaceutical company will reduce its number of vials of vaccine delivered to Europe against the coronavirus, after the decision of the European medical agency of January 12 to consider that a vial contains six doses of vaccine instead of five.

Given this new calculation, production difficulties, and having received orders in number of doses and not of vials, Pfizer therefore decided to deliver fewer vials to the European Union, arguing that the number of doses would be equivalent.

Can this new calculation put the vaccination campaign in Europe in danger?

"20 Minutes" takes stock.

What are we talking about ?

Originally, Pfizer vaccine vials officially contained five doses.

But very quickly, the vaccination campaigns showed that the vials were made in such a way that with the right methodology and the appropriate equipment (in particular a specific syringe), it was possible to extract a sixth dose from the vial, Pfizer having seen wider than expected in the volume.

An excess volume such that it makes it possible to extract an additional 0.3 milliliter from the bottle, ie a sixth dose.

In order to regularize this practice, the European Medical Agency formalized the fact that a Pfizer vial contained six and not five doses of vaccine on January 12, a decision followed by Pfizer itself.

The laboratory, which is experiencing production difficulties, and already announced to Europe last week that there would be some delivery delays, has decided to actually reduce its number of vials delivered to each country, indicating that the number of doses would however be similar.

Suppose France has placed an order for 120 doses of vaccine.

Before this officialization, she would have received 24 vials (24 x 5 doses = 120, the count is good).

But now that Pfizer has formalized the sixth dose, she will only receive 20 (20 x 6 = 120, you are still following).

Dose orders actually amount to millions and not hundreds, which makes a hell of a difference in production.

Is this sixth dose a discounted dose?

"No", slices away the palliative care doctor Laurent Fignon.

“If you vaccinate six people with a single Pfizer vial, there won't be one person less well vaccinated than the others.

The sixth dose is a total dose, complete and as effective as the others.

"

The only subtlety, its extraction requires the availability of suitable equipment: crimped needles and suitable syringes, with very small dead spaces to limit losses.

Dead space is the volume in which a certain amount of liquid remains after the syringe plunger is fully depressed.

Very vulgarly, it is therefore a lost liquid.

Since the vaccine no longer has a bonus volume, each milliliter counts, and only precise equipment allows not to lose too much volume.

Indeed, if we do not manage to draw 0.3 milliliter for the sixth dose, it is on the other hand considered to have lapsed.

The problem is not with a worse sixth dose, but with a precise volume.

Did the European agency shoot itself in the foot?

We could indeed think that we have just lost a super bonus dose and that the European Medicines Agency would have done better to say nothing in order to take advantage of this excess dose while having more vials.

In reality, the decision of the European Medicines Agency is rather a luck.

Laurent Fignon explains: “There is marketing authorization in medicine, the MA.

As long as the European agency had not validated this sixth dose, a Pfizer vial contained only five official doses, and using this sixth dose put the caregiver out of Marketing Authorization.

»In the event of a problem or a lawsuit, a doctor who complied with the MA is not at fault, since he followed the procedure.

In the case of the sixth dose, a vial officially containing only five, the latter was technically delivered out of frame.

Now, caregivers are fully covered when providing a sixth dose.

Not to mention the dangerous Pandora's Box which consisted in letting an unofficial practice last ...

That's not all.

“Pfizer has production problems, there will be fewer vials delivered than expected, sixth dose or not.

In fact, this sixth dose is a blessing, ”says Laurent Fignon.

As for the necessary equipment, “the formalization by the European Medicines Agency will push States to provide themselves with suitable syringes and needles.

There is a sixth dose, up to the nations to make it available, ”adds the doctor, who also recalls that before this formalization, Twitter was drowned in sometimes delusional tutorials on how to draw this sixth dose.

With the official framework, there is now a clear and defined course to follow, far from sometimes dangerous improvisations.

France has already indicated for its part to provide a massive supply of crimped needles and deliver the CHUs, which then take care of distributing them across their territories.

The sixth dose exists, and there is no longer any excuse for wasting it.

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