Extra doses of COVID-19 vaccine approved

The European Medicines Agency (EMA) has confirmed that health authorities can extract six doses of vaccine from each vial of Comirnaty, a vaccine against COVID-19 manufactured by Pfizer/BioNTech.

The vaccine was authorised in the EU on 21 December 2020.

Previous advice had stated that each vial contained five doses but skilled health professionals using special syringes have reported getting an extra dose from each vial – potentially increasing by 20% the number of people that can be vaccinated.

In order to extract six doses from a single vial, low dead-volume syringes and/or needles should be used, the Agency said. The low dead-volume syringe and needle combination should have a dead volume of no more than 35 microliters. If standard syringes and needles are used, there may not be enough of the vaccine to extract a sixth dose from a vial.

‘If the amount of vaccine remaining in the vial after the fifth dose cannot provide a full dose (0.3 ml), the healthcare professional must discard the vial and its contents,’ the regulator said. ‘There should be no pooling from multiple vials to make up a full dose, and any unused vaccine should be discarded six hours after dilution.’