COVID-19 Vaccine Dosage and Low Dead Volume Syringes: Maximizing Vaccine Utilization, Summaries of Clinical Medicine

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COVID- 19 Vaccines and

Low Dead Volume (LDV) Syringes

Change in doses per vial of Pfizer-BioNTech vaccine

• Health Canada has authorized a change in the number of doses per vial in the Pfizer-BioNTech product from 5 to 6
• The volume of vaccine in the vial is 0.45 mL to which 1. mL of normal saline diluent is added for a total of 2.25 mL
• Each dose of Pfizer-BioNTech vaccine is 0.3 mL so should be able to obtain 6 doses as long as: - Diluent is added at 1.8 mL and each dose is 0.3 mL - Little vaccine is left in the injection equipment - Little wastage in drawing up 2

Low Dead Volume Syringes Low Dead Volume (also called low dead-space) is the amount of fluid remaining within the syringe and needle after injection is completed 4 In the absence of the LDV syringes a regular 1ml syringe or a 3 ml syringe is still usable. Vaccine should not be withheld in the absence of the LDV syringes Figure from Zule et al Harm Reduction Journal (2018)

Process to Assess the Dead Volume of a Syringe: Based on ISO 7886 Annex C^5 Fill up whole volume with water Weigh Empty Syringe (A) Empty water Reweigh syringe (B) Dead Volume = Reweighed Syringe – Empty Syringe (B) – (A)