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Upon closer inspection, US healthcare workers have noticed excess dosages leftover in the vials of the Pfizer/BioNTech vaccine. After safely administering the new shots, staff noticed there is always a little extra. 

“They initially thought that they had incorrectly done it because there was so much left in the vial after they pulled up the five doses,” Erin Fox, Senior Pharmacy Director at the University of Utah told The New York Times. “They sent us a picture and were like, can we use the extra?”

The Food and Drug Administration responded to healthcare workers’ queries via Twitter Wednesday. They stated that pharmacists can utilize what remains if it is a full dose. The extra can be used safely but they have advised against using multiple vials to concoct a full dose.

Given that the Covid19 vaccine is so valuable at present you may be wondering why a company might supply more than is needed. 

There are a number of reasons but first and foremost it is simply standard practice for injectable drugs to add a little more. In a liquid form, a drug can cling to the vial and spillage can occur when using a syringe. To ensure that the patient isn’t under-dosed the companies provide a little excess to be sure there is no significant content loss. The amount is almost imperceptible, typically microliters. But even so, it is better to be on the safe side. If the manufacturers were to provide solely enough for five exact doses they would run the risk of leaving some vials short. This could equate to a patient being left short.

So you can see, having too little is problematic. likewise having too much can also be an issue. With a lot of excesses, it is theoretically possible to give a patient too much, though it is unlikely. A much bigger issue though is that excess can lead to misuse because the temptation is higher.

In addition to these risks, there is the monetary factor. For pharmaceutical manufacturers, it can become very expensive accumulatively for them to include the leftovers.

With these factors to consider in 2015, the FDA drafted up a set of guidelines to make sure that the ‘overfill’ was regulated and controlled for everyone to benefit. However, as there are a plethora of drugs and vaccinations that can be injected the information is vague at best. Many of these medications are in different quantities per prescription. So it is difficult to prescribe a one vial fits all solution. With a single dose vial, they recommend less than enough for a second dose to be added as overfill. But for multi-dose vials, they have opted for a set quantity in a total of 30mL. There is some leniency, larger dosages are subject to a special circumstance protocol. The Pfizer/BioNTech vaccine is well-under the limits. Each multi-dose vial contains 0.45 mL. This vaccination solution is then diluted using a saline solution (1.8 mL) of saline solution. One dose is 0.3 mL which is why there is enough left-over for a dose or sometimes two depending on the circumstances. 

For the time-being, the extra vaccine is not being used. The product was only distributed and shots have only just started. During the time it took to start rolling them out and the FDA’s tweet acknowledging the extra doses many were discarded

Now with the knowledge that they can be used, the fate of the leftovers is being discussed. As the vaccine requires a full second dose around 3 weeks later. Some professionals are worried they may run-out before patients get their second shot. The shipments aren’t guaranteed as in place quite yet due to administrative problems. So for now, healthcare workers want to make sure those who have had their first injection get their second with priority.

The FDA is working closely with Pfizer who say that Vaccinators need to consider the policies of their institution you can read more in this article for STAT.

100 million doses of the Pfizer / BioNTech vaccine have been ordered within the US in the hopes to vaccinate up to 50 million people. There are also a further 200 million doses of the Moderna vaccine due to arrive as well. are on With 328 million people there is a lot to consider when it comes to making the extra doses count.

For more information, you can read what Mary Beth Griggs had to say in her recent update for theverge. Here are the latest related articles to keep you up to date on the Covid 19 pandemic.

Studies and findings

How effective is wearing a mask?

There are no standards for the mask these days and yet, some governmetn agencies are ready to bring some change to that. (Sheila Kaplan/The New York Times)

How corona spreads on public transportation

Researchers are planning to study how aerosols move around out of service buses trains and cars. This is with the hopes to learn how covid could spread on public transportation(Paul Berger for the/The Wall Street Journal)

Could this be the start of something worse? A wild mink in Utah has COVID-19

Did you know that animals are vulnerable to COVID-19 too? Here’s a deep dive into the topic. (Brian Resnik/Vox)

Yes, COVID penis is a thing

Erectile dysfunction is being noted as a side effect of covid recovery, how common is as yet unknown but researchers are trying to study the symptom. (Wudan Yan/Elemental)

Recent leads and developments

Moderna COVID-19 vaccine approved by the FDA for US rollout

The FDA authorized a second COVID-19 vaccine to be used in the US. This vaccine will start to be distributed in the US this week. (Nicole Wetsman/The Verge)

‘I haven’t even told my wife’: The secrecy surrounding the naming of the new vaccines.

Read how pharmaceutical companies are choosing the names for their COVID-19 vaccines, even though it’s still too early to name them. (Damian Le Garde/STAT)

Vaccines side effects need to be discussed

Both vaccines currently authorized by the FDA have side-effects. With the vaccination campaigns underway and the first shot being administered, there is a strong need for discussion to make sure people are well-informed. (Maryn McKenna/Wired)

COVID-19 may have permanently altered the development timetable for other vaccines

The timeline of vaccine development shrank dramatically over the past year. Some of those changes will last — others won’t. (Annalisa Merelli/Quartz)

Covid-19 related quotes

“I almost could cry talking to you now… I feel like I didn’t just get a vaccine, I got a shot of hope. It’s hoped that this is the beginning of the end of this terrible pandemic that we’ve all been experiencing — but us on the front line have really seen the suffering and the tragedy associated with it.”

—Dr. Maggie Hagan, the director of infection prevention at Ascension Via Christi hospitals in Kansas tells The New York Times.

Cedars-Sinai Medical Center was one of the first hospitals to receive their supplies of the vaccine. One patient asked: “If I donate $25,000 to Cedars, would that help me get in line?’” Dr. Jeff Toll of course declined the offer.

—Laura J. Nelson and Maya Lau report on how some are trying to pay to jump the queue for The Los Angeles Times.

A number update

Worldwide positive cases are now in excess of 75,508,468. We wish them a safe recovery. Over 1,671,770 people have died worldwide, 313,246 of which were in the US.

The pandemic is not yet over but with vaccines on the horizon, there is a light at the end of the tunnel, stay safe.

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