More than 100,000 Pfizer vaccine doses 'could have been thrown out' amid guidance change

Rebecca Speare-Cole
·4-min read
Practice Nurse Tina Sutton draws off a single dose from a vial, which can provide 10 individual doses to patients, of the Oxford University/AstraZeneca COVID-19 vaccine, being used at the Pontcae Medical Practice in Merthyr Tydfil as the NHS ramps up its vaccination programme with 530,000 doses of the newly approved jab available for rollout across the UK.
The NHS is ramping up its vaccination programme. (PA)
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More than 100,000 doses of the Pfizer/BioNTech vaccine could have been thrown away after Public Health England (PHE) took weeks to revise its guidance on dosages, doctors have said.

The initial instructions on administering the vaccine when the UK approved the jab at the beginning of December said that five doses could be obtained from each vial.

But by December 17, Britain’s medical regulator MHRA confirmed to the Daily Mail that “small” amounts of the jabs were actually going unused.

The same day, NHS England issued guidance to the heath staff on that vaccinators could administer a sixth dose after MHRA had approved the sixth dose.

Read: Police crackdown on lockdown rule breakers amid record number of COVID deaths

Between December 8 and December 20, government figures show that 600,000 people received the Pfizer vaccine in the UK.

This means that if the extra dose in each vial was not used before December 17, up to 100,000 doses could have been thrown out.

But it is also understood that some healthcare staff have been unaware of these changes to the guidance so even more doses may have gone to waste.

This is because the PHE patient group direction (PGD) - a legal framework that allows some registered health professionals to supply or administer medicines - was not revised to until January 4.

HYDE, ENGLAND - JANUARY 08: A man sits in his car as he is administered the Pfizer/BioNTech coronavirus vaccine at a drive-thru COVID-19 vaccination centre at Hyde Leisure Centre on January 08, 2021 in Hyde, England. The coronavirus drive-through vaccine centre is believed to be the first in the world. (Photo by Christopher Furlong/Getty Images)
A man sits in his car as he is administered the Pfizer/BioNTech coronavirus vaccine at a drive-thru COVID-19 vaccination centre at Hyde Leisure Centre. (Getty)

It comes as Boris Johnson confirmed that as of January 7 over 1.5 million across the UK have received either the with the Pfizer and Oxford jabs combined as the Moderna vaccine was approved.

Prof Sir Sam Everington, chair of Tower Hamlets CCG, told the Telegraph that the rules should have been made clear earlier to avoid vaccines being needlessly wasted.

He said: “It’s just mortifying. I don’t know how many were lost in the process by nurses and GPs but I was incredibly frustrated, because I wanted them to mandate the six doses far earlier.”

He added: “We got information that, actually, you could do six, but what they didn’t do was change something called the PGD. And that’s the ruling that nurses abide by. It took too long to come out with the PGD.”

Dr Mary Ramsay, head of immunisation at PHE, said: “The NHS issued guidance on the sixth dose to the health system in December and the relevant regulations were amended shortly after. Therefore, clinicians could and were using the sixth dose before the PGD was published.”

Watch: COVID: Hundreds of thousand of daily coronavirus jabs by next week

Meanwhile, vaccine minister Nadhim Zahawi also told ITV that doctors do know about the sixth dose guidance.

He said: "That’s actually gone out to doctors. They do now know that.

“To go to a six dose regime you have to go back to a regulator and make sure you do it properly and carefully.

Zahawi added: "You have to put the evidence before them to allow the vaccinators to be able to use a six dose. That has gone out to all the sites that they can use the six dose."

He also said the guidance may change for the Oxford jab dose numbers, saying: “You’ll see an optimisation of the AstraZeneca vaccine as well because we think there is also an opportunity to go from 10 doses to 11 doses, which makes a huge difference to the speed we can vaccinate and protect more people."

MHRA says each vial arrives at a vaccination centre with 0.45ml of the Pfizer jab.

Doses must be mixed with 1.8ml of a sodium chloride solution before they are administered, which brings the total amount of liquid per vial to 2.25ml.

Each jab is delivered in 0.3ml doses which means the 2.25ml can theoretically provide as many as seven and a half shots. It is normal for manufacturers to overfill vials to safeguard against spills and waste.

Read: 50 areas of England now have more than 1,000 COVID cases per 100,000 people

The UK is not the first country to have revised its advice on Pfizer doses.

The US Food and Drug Administration clarified on December 16 that extra doses from vials of the vaccine should be used if a full dose can be extracted.

Israel also said the sixth Pfizer dose should be used on December 24.

Meanwhile, in the EU, the European Medicines Agency recommended revising the instructions to clarify that the vials contained six vaccine doses on Thursday.

Yahoo has also contacted The Department for Health and MHRA for comment.

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