Thousands of extra doses of Pfizer vaccine included in first shipment are a ‘godsend,’ Alaska providers say

As providers around the country this week began administering the first doses of a COVID-19 vaccine, many were surprised to find that each vial of vaccine contained enough for six or even seven doses of the vaccine, rather than the anticipated five.

That means that Alaska’s first shipment of vaccine from Pfizer and BioNTech could contain more than 7,000 extra doses, on top of the 35,000 that had initially been allotted.

It’s all going to get used, state health officials said this week.

“We don’t want to waste any vaccine,” said Dr. Bruce Chandler, a medical officer with the Anchorage Health Department, during a briefing on Friday. “The goal is to vaccinate as many people as possible.”

The decision to use the bonus doses follows recommendations from the Food and Drug Administration, which said this week that it was acceptable for pharmacists to use every full dose left over in each vial “given the public health emergency,” and that it was consulting with the drug companies to determine future steps.

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The amount of vaccine that providers are able to pull is dependent on needle size, said Tessa Walker Linderman, the lead for the Alaska COVID-19 Vaccination Task Force.

Needle size matters because thicker needles leave residue of more vaccine inside, while smaller needles leave less.

“So as a state we are recommending that if you can guarantee the needle size you use for the first dose will be the same for the follow-up second dose, you will be able to pull a second dose,” she said.

How the extra doses will be used poses a challenge statewide: The vaccine is a scarce resource, and already an advisory committee has had to make difficult decisions about which health care and frontline workers to include in the initial phases.

“We have more people in the initial groups that are eligible to get vaccinated than we have vaccine for,” said Dr. Janet Johnston, epidemiologist with the Anchorage Health Department.

“So even if we get an extra 20%, we certainly have those people available without having to go beyond those initial groups,” she said.

Currently eligible in Alaska are hospital-based frontline medical workers, long-term care facility residents and staff, EMS and fire personnel providing medical services, community health aides and practitioners, and people required to perform vaccinations.

But many other health care workers — including rural, non-certified emergency responders — have so far been left off the list due to limited supply.

Alaska’s vaccine allocation committee is expected to announce a decision soon about who else to include next.

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That decision could also partly influence who receives some of the excess doses, said Robert Barr, who helps run Juneau’s coronavirus response.

He said his team has begun using the extra doses already, and they’re waiting to hear what the allocation committee decides before they use them all up.

Juneau has received about 1,000 doses so far, including 500 allocated for hospital staff, 90 for emergency medical responders and the remaining 400 or so for long-term care facilities, Barr said.

In Fairbanks, where 2,000 doses have been received so far, the plan for the extra vaccine is also to follow FDA guidance and stretch the allotment as much as possible, said Dan Nelson, head pharmacist at the Chief Andrew Isaac Health Center in Fairbanks.

“The beauty of it is that we didn’t have truly enough vaccines to include everyone identified as eligible in the first group,” Nelson said. “So the fact that we are able to get more is a godsend.”

In the Yukon-Kuskokwim Delta, some of the extra Pfizer doses allocated by the Indian Health Service are likely going to go to elders, said Tiffany Zulkosky, vice president of communications with the Yukon-Kuskokwim Health Corp.

They are still working out the exact details of the plan, she said.

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