Alberta’s health minister and chief medical officer of health say there is “misinformation” circulating online about COVID-19 vaccine going to waste in the province.
Tyler Shandro and Dr. Deena Hinshaw issued a joint statement Tuesday morning to “definitively address this inaccurate information.”
The statement came as 843 new cases of COVID-19 were reported in Alberta Tuesday afternoon, along with 26 additional deaths from the disease. (See full COVID-19 data below).
In the statement, the health officials said in all large-scale immunization programs, some wastage will occur and a “minimal amount of vaccine will be lost when drawing doses or if a vial is dropped or spilled.
“While this is upsetting, it is unavoidable. It is also extremely limited thanks to the processes in place,” the statement reads.
“In fact, the COVID-19 immunization program to date has had significantly less wastage per administered dose than what occurs in a typical influenza immunization program. In fact, wastage in the COVID-19 vaccine program is at 0.3 per cent, and typical immunization programs can see wastage around six per cent.”
The province did not specify the “misinformation” it was referencing. However, a tweet posted late Monday night by an assistant professor with the University of Alberta’s Faculty of Medicine & Dentistry gained a lot of traction online and garnered a response from Alberta Health Services.
In the tweet, Dr. Tehseen Ladha said she has heard from health-care workers who say “unused doses of COVID-19 vaccine in opened vials are being discarded at the end of the day.”
AHS responded to the claim on Twitter, saying it is “rapidly immunizing as many Albertans as quickly as possible, ensuring vaccine doses are utilized. There have been no reports of significant vaccine wastage.
“If and when we have an appointment cancellation, we administer the allocated dose to the next person in line. Any currently unused doses are going to be administered to eligible Albertans in the coming days,” AHS said.
In their statement, Shandro and Hinshaw went on to say that in the early planning stages of immunization, AHS was asked to “devise a strategy to ensure that the risk of vaccine wastage was minimized.”
They added they are also exploring ways to further reduce wastage.
“Doses are thawed and prepared according to pre-scheduled appointments, and appointments are overbooked to ensure that enough health-care workers are always in line,” the statement reads.
“If a scenario arises where staff have no booked appointments left but there are thawed doses available, those administering the vaccines are able to vaccinate each other. The vaccine cannot be re-frozen or put in a fridge.”
Canada’s chief public health officer Dr. Theresa Tam was asked about the situation on Tuesday, but said she had not personally heard of any reports of vaccine wastage.
“I don’t know of any reports that have been forwarded to us in terms of vaccine wastage,” she said.
“I think just prior to the Christmas period, we heard that from the manufacturers that you can — if there’s actually enough for another dose from the Pfizer’s vial — you could use that. There may be other reasons why all the dose is not used.”
In mid-December, Hinshaw said that each vial of the Pfizer-BioNTech COVID-19 vaccine typically contains five doses. However, it’s possible some Pfizer vials could contain enough of the COVID-19 vaccine for six doses.
“When creating these vials, there is enough put in the vials to make sure that there is a guaranteed five doses in each vial. If you have a very skilled immunization administrator who is able to withdraw exactly the amount needed and no more, it is possible that some vials may be able to provide enough for six doses of vaccine,” Hinshaw said on Dec. 17.
“That is something that our immunizers are looking at and when possible, that of course we will be able to provide those extra doses whenever that vial is handled in such a way to make that last dose available.”
Dr. Yan Yu is a family doctor in Calgary who works in a number of settings, including clinic, long-term care and psychiatric emergency medicine.
He shared an AHS memo dated Dec. 31 on Twitter that states the vials of vaccine are labeled with dosage amounts of five or 10. In the memo, AHS adds that the vials “may or may not” contain more than the five or 10 dosage amounts.
“Although additional vaccine may be remaining in the vial once the five or 10 doses has been administered, it is important to note the manufacturer has not consistently or intentionally provided this as an extra dose,” the memo reads.
“It is extremely important we are ensuring practitioners administer to the client the whole required dose of vaccine; therefore, it has been decided to ignore the undetermined leftover vaccine, do not attempt to extract an extra dose.”
In December, the U.S. Food and Drug Administration said that extra doses from vials of Pfizer Inc’s COVID-19 vaccine can be used. Yu said he is curious why Alberta wouldn’t recommend the same practice.
“It’s a bit disheartening to hear that nurses are actually being actively discouraged from saving as much vaccine as possible,” Yu said.
“I’m not necessarily saying to extract everything from the vial, because I do acknowledge that there is wastage, but there still should be enough — if the process is done as precisely as possible and as consistently as possible — there should still be enough to get that sixth dose.”
In a statement, AHS said the memo was sent out to staff in the Calgary zone only.
“AHS is committed to safely and effectively using all vaccines the way they are packaged for use. Regarding Pfizer vaccine specifically, when a sixth dose can be clearly and safely extracted staff are supported to do so. The intent of this memo was to provide staff with the confidence to use the vaccine as it is packaged for intended use (five doses) without the pressure to retrieve a sixth dose if they felt a particular vial could not effectively provide one,” AHS said.
Vaccine waste does happen, infectious disease specialist says
Dr. Craig Jenne, an infectious disease specialist at the University of Calgary, acknowledged that with most conventional vaccines, some waste does happen.
“Every year we buy more influenza vaccine than is actually administered. We need to ensure we have enough. It’s probably more concerning when the vaccine is a precious resource such as the current COVID vaccine,” he said Tuesday afternoon.
“But that being said, we do have to understand the logistics of administering vaccine and it is essentially impossible to make 100 per cent of doses available at every location,” Jenne explained. “We do have to keep in mind that we’re administering vaccine at multiple sites, each with its own storage facility. Once we thaw the vaccine, there’s a very limited time window which it can be deployed.
“So I appreciate they’re doing everything in their power to minimize vaccine loss, but any loss is still disappointing and we would obviously want to see policies evolve. If we can identify a common reason for vaccine loss and we can address that, then that would be great moving forward.”
The province’s statement said health-care workers are working around the clock to execute Alberta’s COVID-19 vaccination program.
As of the end of day Jan. 4, Shandro said 26,269 doses of COVID-19 vaccine had been administered in Alberta.
Shandro added about 3,000 doses are being administered each day and by the end of Tuesday, a total of about 29,000 doses will have been handed out — the goal the government initially hoped to hit by the end of December, but missed by a few days.
“I hope to see the daily number increase but I emphasize again, it depends when the shipments come,” Shandro said.
“We’ll get the vaccines out as soon as we get them in.”
Shandro added the next shipment of vaccine was “in the air as we speak,” on its way to Alberta. Hinshaw said this week’s shipment includes about 13,000 Pfizer vaccine doses.
Shandro assured Albertans the workforce is in place to administer the vaccines as they arrive.
“A lot of this is numbers of shipments and the number of amounts we’re receiving of doses, being able to coordinate if doses are arriving from Pfizer on one day, and then the next day. Or Moderna on one day and then the next day. How many of those doses are arriving, when they’re arriving is out of our hands,” Shandro said.
The Official Opposition is calling on the government to provide daily online reports of vaccinations administered on a regional basis, inventory levels and anticipated incoming shipments.
The NDP says Albertans are holding onto the hope a vaccine offers, but are losing faith in the province’s vaccine process and leadership itself after several MLAs travelled internationally over the holidays.
“It’s very difficult for Albertans to take statements from the Kenney government at face value after their trust was so completely betrayed,” NDP Health Critic David Shepherd said.
“It’s time to put the facts on the table for everyone to see. I’m confident AHS is tracking these numbers closely — they should share this information with Albertans today and every day until all Albertans have an opportunity to be immunized.”
Alberta’s COVID-19 data for Jan. 5
The 843 cases identified Tuesday came after about 10,300 tests were performed, Hinshaw said, which puts the positivity rate at around 8.2 per cent.
As of Tuesday afternoon, there were 919 people in hospital with COVID-19, 140 of whom were being treated in intensive care.
Hinshaw said Alberta is seeing a stabilization of cases, with “occasional days” of low new cases due to lower testing volumes.
“Overall, new case numbers, hospitalizations and ICU admissions for COVID-19 are still very high in our province,” she said.
“Our health-care system remains under significant pressure.”
Of the 26 deaths reported Tuesday, 11 were in the Calgary zone, 10 were in the Edmonton zone, three were in the North zone, one was in the South zone and one was in the Central zone.
Alberta’s death toll has now reached 1,168.
“My heartfelt condolences go to the family and friends of these individuals, and also to anyone who is mourning a loss of someone they loved,” Hinshaw said.
One of the deaths was a health-care worker in the Edmonton zone, Shandro said. The worker was a woman in her 50s from the Edmonton zone. The woman’s death marked the second health-care worker’s death due to COVID-19 announced in Alberta in as many days.
Read more: Alberta health-care worker dies of COVID-19
Of the deaths in the Edmonton zone, six were linked to outbreaks.
A man in his 90s who was linked to the outbreak at Chartwell St. Albert Retirement Residence, a woman in her 80s who was linked to the Garneau Hall outbreak, a man in his 80s who was linked to the Chartwell Heritage Valley outbreak, a woman in her 70s linked to the Kiwanis Place Lodge outbreak and a man and woman in their 90s both linked to the outbreak at Rosedale Estates have all died. Comorbidities were present in all cases except in the case of the woman linked to the Kiwanis outbreak. According to Alberta Health, comorbidities are unknown in her case at this time.
Two men in their 70s, a man in his 80s and a woman in her 50s have also died from COVID-19 in the Edmonton zone. Alberta Health said comorbidities were unknown in the case of the woman in her 50s. The other three had known comorbidities.
Of the 11 deaths reported in the Calgary zone, nine were linked to outbreaks, with four of those linked to one outbreak. Two men in their 80s, a woman in her 80s and a woman in her 90s who were all linked to the outbreak at the Agecare Walden Heights outbreak have died. All four cases included comorbidities.
A woman in her 80s who was linked to the outbreak at Agecare Skypointe and a man in his 80s, a man in his 90s and a woman in her 100s who were linked to the outbreak at Bethany Calgary have died. All cases included comorbidities, according to Alberta Health.
A woman in her 80s who was linked to the outbreak at McKenzie Town Retirement Residence has also died. Alberta Health said comorbidities are unknown at this time.
There were two deaths in the Calgary zone not linked to an outbreak. A man in his 70s with unknown comorbidities and a woman in her 80s with known comorbidities have both died.
There were three deaths reported from the North zone. All three included comorbidities.
A man in his 70s linked to the outbreak at Heimstaed Lodge and a man in his 70s linked to the outbreak at the Grande Prairie Care Center have both died.
A man in his 70s not linked to an outbreak has also died in the North zone.
A man in his 60s has died in the South zone and a man in his 90s linked to the outbreak at Coronation Long-Term Care in the Central Zone have both died. Both cases had known comorbidities.
With files from Kirby Bourne, Global News.
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