Alarms were raised this spring and summer about potential shortages of vaccine-related products. Despite the uncertainty, industry experts expressed confidence the country would avoid situations such as the PPE shortages experienced earlier in the year.
The race to develop a COVID-19 vaccine has been in the public eye since spring. The race to provide enough needles, syringes and glass vials to administer it has been somewhat lower key. Still, it hasn’t been without nervous moments.
For example, in early May, Rick Bright, former deputy assistant secretary for preparedness and response and director of the Biomedical Advanced Research and Development Authority (BARDA), warned that the nation’s stockpile of needles and syringes was only 2% of the required amount. (In addition to anticipating a two-shot vaccine, Bright’s calculations included about 180 million more syringes for an increase in requests for flu shot, reported USA Today.)
Questions about the vaccine remain. For example, when will it be available? How quickly will it be rolled out? Will it be injected, or taken orally or nasally? Will it be delivered in pre-filled syringes? Will one injection be enough to achieve immunization, or will two injections be needed? How many Americans will actually get vaccinated?
Feds take action
The federal government has taken an active role, contracting for 820 million syringes, including 420 million by the end of 2020 and the rest in 2021, reported USA Today.
- In May, BARDA – part of the Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response – awarded contracts for needles and syringes for approximately $110 million to Retractable Technologies (Little Elm, Texas) and Marathon Medical (Aurora, Colorado) for 320 million needles and syringes, and to Franklin Lakes, New Jersey-based Becton Dickinson for approximately $11 million for 50 million units of needles and syringes.
- Also in May, the Department of Defense and HHS announced a $138 million contract with ApiJect Systems America for U.S.-based manufacturing capacity that could produce approximately 100 million pre-filled syringes using the company’s “blow-fill-seal” technology in 2020, and more than 500 million through 2021.
- In mid-July, Smiths Medical announced a partnership with BARDA and the Department of Defense to expand capacity at its facility in Keene, New Hampshire, for production of integrated hypodermic needle and syringe products to support COVID-19 vaccination. The federal government will have priority access to this expanded capacity for vaccination efforts dedicated to COVID-19, flu vaccines, and future pandemics.
- In July, BD announced a partnership with BARDA to develop new manufacturing lines for injection devices that would provide priority access to the U.S. government for hundreds of millions of syringes and needles to support current and future pandemic vaccination efforts. BARDA agreed to invest an estimated $42 million into a $70 million capital project to further expand BD’s operations and manufacturing capacity in Nebraska. The new capacity was expected to be online within 12 months. Later that month, BD signed an agreement with BARDA for 140 million injection devices for the U.S. market.
“We’ve been very clear that these large pandemic orders will not affect BD’s ability to fulfill existing customer requirements for needles and syringes, including the annual flu vaccination and childhood immunization campaigns,” BD spokesperson Troy Kirkpatrick said in mid-July. “We have capacity to manufacture hundreds of millions of syringes between now and January, but if governments wait too long, there will not be enough manufacturing capacity across the global industry to make billions of devices in a month or two.
“A vaccination campaign the size and scope of an entire country/world isn’t something that happens in a month,” he added. “It will be the better part of a year to get everyone inoculated, so even if the new lines don’t come online for 12 months, there could still be a significant need for devices at that time.”
Avoiding panic buying
Terry Altshuler, portfolio executive for Vizient Inc., said that needle-and-syringe suppliers indicate they have a surplus of product due to the decline of non-essential procedures that accompanied COVID-19. “In addition, suppliers are factoring in the possibility of a vaccine being available and making the necessary preparations,” he said. “While they are allocating product to an extent, the intent is to avoid ‘panic buying’ and ensure that facilities throughout the country are able to obtain product.”
Mittal Sutaria, Vizient’s vice president, contracting and program services for pharmacy, said that as of mid-July, Vizient was not aware of any members attempting to stockpile needles and syringes. “After the government began placing orders for needles and syringes in May in anticipation of a vaccine for COVID-19, most manufacturers and distributors put their products on protective allocation to prevent anticipatory purchasing by providers and to help ensure that available product is distributed as evenly as possible across all healthcare settings,” he said.
“From a vaccine perspective, there are still too many unknowns when it comes to considerations for creating a stockpile. The allocation of vaccine will involve many stakeholders, including manufacturers, distributors, hospitals, government and public health entities.”
Right measures and steps
Chaun Powell, group vice president of strategic supplier engagement at Premier Inc., said that Premier members anticipate having enough needles and syringes to get through flu season and COVID-19 vaccines. “Lead indicators show that providers and supply chain stakeholders are taking the right measures and steps to be prepared,” he said.
“Over the next 18 months, we, as a nation, will have contracted to create more than 870 million syringes above normal production, which exceeds 5 billion syringes for the acute domestic healthcare industry alone. In addition, the private sector is also ramping up its production output. Assuming there are no unforeseen external variables, we anticipate having enough syringes.”
The situation with needles and syringes differs from that faced with N95s earlier in the year, he added. “With N95s, we, as a country, went from a national consumption rate (specific to acute healthcare) of approximately 25 million masks annually to over 300 million. The twelve-fold increase was unsustainable. With syringes, our baseline is 5 billion consumed annually in the acute space. Adding another 800+ million syringes indicates an approximate 20% increase, but it is no comparison to the twelve-fold impact we saw with masks.” What’s more, the U.S. healthcare supply chain has had the time and foresight to increase production and inventories of needles and syringes, he said.
Premier members express confidence that their physician practices will have enough needles and syringes to meet upcoming demand, added Powell. “In our June survey of acute care members, we asked our members how adequate they felt their inventory of vaccines was in physician offices. Eighty-three percent said they had an adequate supply, and in fact, a small number (2%) noted they were overstocked due to the decrease in other procedures.”