Syringe shortage could hamper administration of Covid-19 vaccine, experts warn | Coronavirus epidemic

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As the coronavirus vaccine race heats up, the United States faces another potential crisis: a syringe shortage.

The US federal government has already spent hundreds of millions of dollars in hopes of averting a syringe shortage, if and when a Covid-19 vaccine is approved. It comes as shortages of personal protective equipment continue to hamper the United States’ response to the pandemic.

A potential vaccine could receive emergency approval as early as winter 2020. But industry leaders and experts warn that the United States has only a short window of time to increase the supply of the vaccine. syringes to cope with the large number of inoculations needed to control the pandemic.

The greatest danger of a shortage will not come from the first wave of a potential vaccination program, but from the second and third waves in 2021. Then, manufacturers will need to roughly double their capacity to meet demand in the United States alone.

This narrows the syringe manufacturing window to just a few months, with the early arrival of a vaccine with the potential to disrupt the supply chain.

“What we have been telling governments around the world is that if you are planning to set up a Covid-19 vaccination program, you have to order it now and not wait for a vaccine to be ready,” he said. said Troy Kirkpatrick, spokesperson for Becton, Dickinson & Co, better known as BD.

BD is the largest manufacturer of syringes in the world, and manufactures more than half of those used in the United States. It has already committed to producing 470 million syringes for the US, UK and Canadian governments.

“Our baseline is already in the billions, and even at that scale, it’s not like we can, say, produce 100 million more this month,” Kirkpatrick said. “That’s why we’re very proactive in letting governments know that you need to place your orders now.”

Not all experts in the field are worried. “Syringes are the easiest part, and I think we as a country are in a great position to deal with it,” said Chaun Powell, vice president of the disaster response group for Premier Inc, a medical supply chain management company.

But others have been warning for some time of a possible syringe shortage. In May, whistleblower and former director of the Biomedical Advanced Research and Development Authority (Barda), Rick Bright, filed a complaint alleging that the US national stockpile contained only 15 million syringes.

Five companies represent the bulk of the US syringe market, making about 663 million syringes a year, all of which are already allocated to other programs such as the flu shot. The Trump administration has estimated that the United States may need an additional 850 million syringes to deliver a Covid-19 vaccine en masse.

Researchers at the Center for American Progress, left, found that about 462 million doses of a Covid-19 vaccine would be needed for the United States to achieve herd immunity, with the syringes needed to administer the vaccine.

In part, the large number of syringes needed is a function of Covid-19. Coronaviruses produce a short-lived immune response in humans. Most experts believe that people will need to be given a second vaccine, or “booster”, if and when a vaccine is put in place.

“The very first phase, we will have enough because we are not going to vaccinate billions of people, we are still going to vaccinate hundreds of millions of people,” said Prashant Yadav, senior researcher at the Center for Global Development and professor and supply chain expert. “In the second and third phases, things get complicated.”

McKinsey analysts believe vaccine makers have the cumulative capacity to manufacture up to 1 billion vaccines by the end of 2020 and 9 billion by 2021 – if a vaccine is approved. And this later period of time is when the overall capacity of the syringes seems most fragile.

“If we have 7 or 8 billion doses in 2021 and 2022, do we have 7 or 8 billion more syringes in capacity? No, ”Yadav says.

Some companies, such as Pfizer, are turning to outside contractors because they face an internal shortage of syringes and vials, according to the trade publication Biopharma Reporter. The hope is to make room for the company’s vaccine candidate production capacity.

A lab technician inspects old syringes that have been put aside by an automatic inspection machine. Photography: Joel Saget / AFP / Getty Images

The US government has turned to companies like BD, which makes 58% of America’s syringes, as well as a number of small businesses.

The federal government has actually doubled the annual revenue of Texas-based Retractable Technologies by giving the company $ 137 million to deliver syringes and increase production. In 2019, Retractable’s revenue was $ 41.8 million, according to the Dallas Morning News.

Another $ 143 million contract for unproven plastic vials lined with a microscopic layer of glass was awarded to Alabama-based SiO2, which was awarded a Barda contract to increase vial production to 120m from here November. SiO2 produced 14 million vials per year, in March.

BD produces 190 million syringes for the US government and expands its production lines in Nebraska with $ 42 million in public cash (as part of a $ 70 million investment). The new capacity will allow the company to produce hundreds of millions of additional syringes per year from 2021.

Additionally, some distributors fear that regardless of capacity, panic buying and inventory will undermine the supply chain. “People are so scared of what happened with N95s that it’s going to continue from product to product,” said Michael Einhorn, president of Dealmed, the largest distributor of medical devices in New York, New Jersey, Pennsylvania. and Connecticut.

“We have seen requests from a particular government agency that wanted to store syringes, and the government agency does not provide health services directly,” Einhorn said. “When people are in a panic… people don’t act rationally.”

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