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Covid-19: What do we know about the late stage vaccine candidates?

BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4576 (Published 24 November 2020) Cite this as: BMJ 2020;371:m4576

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Rapid Response:

Will the vaccines be in Prefilled Syringes?

Dear Editor,

The Royal Pharmaceutical Society guidance on the safe and secure handling of medicines recommends that to minimise manipulation of medicines in clinical areas injectable medicines should be in prefilled syringes (PFS) wherever possible [1]. All media photos of the vaccines show 5ml glass vials but will they be distributed in PFS?

Having the vaccines already in PFS, certainly the ones that don’t require super low temperatures, would greatly improve the mass vaccination process. By not having to prepare the injection on the front line fewer skills and less training will be required and the process speeded up, probably reducing patient vaccinator contact time. PFS will make the process more sterile. Some of the side-effects such as redness and soreness at the injection site may be due to inadvertent contamination during the normal syringe preparation process, reported as high as 6% [2]. Similarly any possibility of viral hepatitis transmission from using multidose vaccine vials and detachable needles will be completely eliminated. If the vaccines are put directly into PFS this would also stop the production of 14 billion unnecessary glass vials, which is more than the annual global production of injectable medicines and avoid the environmental consequences of their disposal.

Dr David K Whitaker FRCA
Chair Patient Safety Committee
European Board of Anaesthesiology

References
1 Royal Pharmaceutical Society. Professional guidance on the safe and secure handling of medicines. 2019. https://www.rpharms.com/recognition/setting-professional-standards/safe-...

2 Gargiulo DA, Mitchell SJ, Sheridan J, Short TG, Swift S, Torrie J, et al. Microbiological Contamination of Drugs during Their Administration for Anesthesia in the Operating Room. Anesthesiology. 2016;124(4):785-94.

Competing interests: Chair of European Board of Anaesthesiology (EBA) Patient Safety Committee. Member ESAIC Patient Safety and Quality Committee. Past member World Federation of Societies of Anaesthesiologists (WFSA) Safety Committee. Invited lecture fees from Aguettant Ltd and Medtronic - all paid to charity Lifebox. Provide consulting services to BD. Note: I have promoted the concept of prefilled syringes for over 20 years, BD make empty syringes and my agreement with them started 2 months ago.

02 December 2020
David K Whitaker
Consultant Anaesthetist
Retired
London