Getting the full six doses from vials of the Pfizer/BioNTech shot –
as allowed this month by the European Union's health regulator –
requires needles that are both thin enough to minimize waste and
long enough to deliver the jab, as required, into the recipient's
shoulder muscle.
Fignon's hospital in the Mediterranean resort of Cannes was sent
needles from the French public health authority that were too short,
he said, forcing it to hunt locally for supplies. Other nearby
hospitals got the right needles and were generous enough to share
some.
"To us, it looks like Russian roulette," Fignon told Reuters. "You
do not know what you will be getting."
Similar shortages are cropping up elsewhere in Europe, complicating
a stuttering start to vaccination efforts that have been compounded
by warnings from Pfizer and AstraZeneca, its Anglo-Swedish peer,
that they will not be able to meet vaccine supply commitments in the
near term.
Pfizer now forecasts it will produce 2 billion doses this year, but
this assumes it will be possible to extract the full six from each
vial. It charges by the dose, meaning the cost of a vial has gone up
20%.
The European Commission is pressing Pfizer and German partner
BioNTech to deliver more of the low-dead-space needles to extract
the extra dose.
BioNTech says it has procured 50 million needles that it can sell at
cost to countries around the world, and is seeking to buy more. That
compares with the EU's order of up to 600 million doses of its
vaccine.
Industry executives say that, while output of needles and syringes
is sufficient to meet current demand, chaotic ordering means that
they often do not get to where they are most urgently needed. Work
is under way to assess future demand and find ways to meet it, they
say.
COORDINATION CALL
In Germany, vaccine distribution is handled by the central
government but its 16 federal states are responsible for obtaining
the needles and syringes needed to inject them - with mixed results.
Some, like Baden-Wuerttemberg and Thuringia, had the good fortune to
order the right kind of needles and syringes early on. But others,
including Bavaria, Saarland and Lower Saxony, didn't and are having
to place follow-on orders, say officials.
Saxony, on the Czech border, is also having to shop around as scarce
supply forces up prices, said Lars Werthmann, regional head of
vaccine logistics at the German Red Cross.
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"We can't afford to forfeit a
single dose at the moment. And we can't justify
failing because of a 5-cent syringe," Werthmann
told Reuters. Europe's leading
maker of injection equipment, a privately owned German company
called B.Braun, says it faces increased demand for syringes and
other products needed for vaccinations.
"With our competitors, we are currently able to cover all demands in
connection with products needed for the vaccinations," said
spokeswoman Christine Bossek. "We are working in parallel on
solutions to ensure that this will also be the case in the future."
German medical technology industry association BVMed said there were
no production bottlenecks and that supplies of syringes and needles
were adequate. But muddled orders were complicating distribution, it
added, calling for better coordination. SHOT
UTENSILS
Switzerland had placed orders for so-called "shot utensils" to
deliver five doses per vial. With six now allowed, it is in talks
with Pfizer to supply equipment needed to draw that number of doses,
the Federal Office of Public Health said.
Officials in Britain, which has made a faster start to its
vaccination drive, say that health teams are well supplied with the
right injection kit.
Back in Cannes, Fignon says he and his colleagues have managed to
extract six doses from the Pfizer vials but this will not last
unless doctors get the equipment they need.
"Some countries had the right equipment from the very start; we did
not here in France," he said.The French health ministry has
acknowledged that extracting the sixth dose was challenging and
required specific equipment. It said it was in the process of
ensuring the right needles and syringes reached doctors.
In addition to BioNTech's pledge to supply needles at cost, Pfizer
said it was in close discussions with the European Commission and EU
governments on their vaccination plans, including "supporting
governments in securing supply of low-dead-space syringes should
they need".
(Additional reporting by John Miller in Zurich, Francesco Guarascio
in Brussels, Alistair Smout in London and Ludwig Burger in
Frankfurt; Writing by Douglas Busvine; Editing by Nick Macfie)
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