Include private entities in Pfizer-BioNTech vaccine administration

THE EDITOR, Madam:

A little over a month ago, the Ministry of Health and Wellness (MOHW), to much fanfare, announced the inclusion of private entities in the administration of COVID- 19 vaccines. This was to improve the access and crowding issues which plagued vaccine distribution in the past. Now that the Pfizer vaccine is available and demand is at a premium, the MOHW has reverted to the very position which it identified as being problematic in the past. It has centralised the Pfizer vaccine distribution, and excluded the private entities from this activity.

The US FDA has approved the Pfizer-BioNTech COVID-19 for administration in children five to 11 years old. This will inevitably lead to increased demand worldwide, and will require appropriate logistical support to facilitate distribution and administration. This Pfizer vaccine has been touted as one of the more difficult to manage and transport due to its requirements for extreme-temperature storage conditions.

The vaccine has three different storage conditions. The first is storage in an ultracold freezer between –90 degrees Celsius and –60 degrees Celsius. In this environment, the manufacturer’s expiry date prevails. The second storage option is in a freezer between –25 degrees Celsius and –15 degrees Celsius. Under these circumstances, the vaccine may be stored for up to two weeks. The third and most relevant storage condition is that of refrigerator storage. “Before mixing, the vaccine may be stored in the refrigerator between two degrees Celsius and eight degrees Celsius for up to one month.” This temperature range of two to eight degrees Celsius is the same temperature range used to store our AstraZeneca and Johnson & Johnson COVID-19 vaccines, as well as our polio, DPT and MMR vaccines. Further, the Pfizer vaccine “once mixed, can be left at room temperature (two degrees Celsius to 25 degrees Celsius) for up to six hours”.

The Pfizer vaccine requires mixing prior to its administration. The mixing and dilution of medication is neither a novel nor difficult activity for healthcare workers. In essence, there is no rational explanation for any qualified member of the health sector to be excluded from this exercise.

Vaccine hesitancy certainly plays a role in our low immunization coverage. In my view, vaccine management and distribution policy are also significant contributors.

DR ORVILLE NEMBHARD