Pablo Sigal
03/01/2021 6:01 AM
Clarín.com
Society
Updated 03/01/2021 6:01 AM
The saga of uncontrols in the vaccination campaign against the coronavirus in Argentina has an extra chapter to which little attention has been paid: the amount of vaccines that may have been applied
above the official figures
, without being recorded.
Regarding the
VIP vaccinated
known so far, it is known that they are those who received a dose without corresponding in order of priority.
But these applications appear in the Integrated Argentine Health Information System (SISA).
There is another category about which even less is known: the possible
“blue vaccinates”.
The issue focuses specifically on the
three batches of Sputnik V
that arrived in
multidose vials
between late December and late January.
The first batch was 300 thousand doses, the second the same size and the third, 220 thousand.
However, that was the official stock: depending on the conditions of use, the doses could yield up to
20 percent more.
The explanation does not escape what usually happens in general with multidose vials: they always bring a surplus.
Only when it comes to the vaccine against the flu, pneumonia or another common illness, the doses are left over.
In the case of Covid 19, they are missing.
It should be noted that with the batch of 400 thousand vaccines that arrived in February, this multidose presentation
changed to single doses.
It was not reported whether in the new batch that arrived this Sunday night, Sputnik continued with this fractionation or has returned to its previous container.
Component 1 of Sputnik V in a 3-milliliter vial, displayed by health personnel.
Photo: AFP
The first 820,000 doses that landed in Ezeiza since December were divided into
3-milliliter vials
, with the indication that each vial should yield five vaccines.
However, each dose requires
0.5 milliliters
.
In this way, the possibility arose that for each vial
one more vaccine
could be used
.
Taken to the totality available, that could imply a yield up to
164 thousand doses higher.
Although that calculation, in reality, would be the most optimistic.
Whether this could happen depended on the
expert hand of the vaccinator
and, also, on having the appropriate syringes so that the doses were extracted from the vials in a millimeter way.
Due to this difficulty, it is unlikely that this
was the rule
with all the vials used.
Precisely because it is a task of maximum precision, for which vaccinators are not always trained, is that the container comes with that extra approximate 0.1 milliliter per dose.
Some of the content can get lost in the so-called
“dead spaces” of needles and syringes.
But if the person who prepares each vaccine has sufficient skill and the necessary inputs, the good at stake is too precious for the yapa to end up in the trash.
Part of the latest batch of one million doses arriving directly from Russia.
Photo: Presidency of the Nation
The concrete thing is that the rendering of accounts in each vaccination center in the country must be made for
the doses officially delivered
.
The "blue" doses did not necessarily have to be loaded into the SISA.
No one was going to ask for an explanation for it.
So it is difficult to determine not who the beneficiaries could be in the cases where these doses have been used, but rather the accounting for them.
An anecdote that circulated in San Pedro gives an idea of the dimension that informal vaccination could have had.
Through local media it was learned that one of those responsible for the operation in that city was ironically nicknamed "the idiot", because when he realized that Sputnik V could render a sixth dose, he not only began to take advantage of it, but
also to register it.
The
Sputnik V Vaccine Manual
, an official text, says nothing about this possibility of extra inoculation.
It is a tutorial that details step by step how to handle the drug and emphasizes the
action times
so that the cold chain is not cut.
The trucks that went to Ezeiza to load the new batch of Russian vaccines that arrived this Sunday.
Photo: Juan Manuel Foglia
An update of the manual, published in February, also warns about the
color of the
vial
caps
: originally those of component 1 were blue and red, those of 2. But then there were also white and green, so it was recommended carefully read the labels written in Russian.
As for the potential sixth dose, it is also not possible to trace it in the brand new
Public Vaccination Monitor
, a website enabled by the Government that all Argentines can access.
It gives an account, supposedly in real time, of the number of doses distributed and applied by province.
If the sixth dose of each vial had been recorded, at some point in the chain the number of doses applied should have been higher than the number distributed.
But this public record was only enabled last week, so the eventual maneuver with Sputnik
is impossible to contrast today
.
The first batch of 300,000 Sputnik V vaccines that arrived in Argentina on December 24.
Photo: Presidency of the Nation
The doses distributed from the arrival in the country of the subsequent batches, both from Sputnik and from Covishield and Sinopharm, means that the total stock delivered in each district is
always greater than that used
.
There the trace of the supposed sixth dose is lost in the whole and requires waiting for a future statistical balance of the vaccination campaign to draw conclusions.
The Russian is not the only vaccine with which this situation occurred.
In Spain something similar happened with Pfizer, but there the sixth dose was
on the table all the time
.
There were even reproaches for some autonomous communities such as Catalonia, Andalusia and Madrid for having wasted the extra injection in a context of scarcity.
They attributed this to the limited availability of pinpoint precision syringes that could allow healthcare personnel to fractionate doses like surgeons with a scalpel.
To use the extra dose, the European Medicines Agency stipulated that the combination of the "dead volume" of the syringe and needle had to be less than 35 microliters (one milliliter equals one thousand microliters).
Therefore, if standard syringes and needles were used, it is likely that there would not be enough to draw the sixth dose from the vial.
On the other hand, the health authorities advised against a practice that common sense in the midst of the "war economy" could have encouraged: collecting
the surplus from several vials
to obtain the additional dose.
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