The Ministry of Health and Population has used syringes supplied by China with the Sinovac-CoronaVac Covid-19 vaccine to inoculate children between five and 11 years old since the COVAX facility failed to supply syringes.

The syringes supplied by China, however, were of 0.5 ml capacity, and meant for adult vaccination, but health authorities have used them to administer a paediatric dose (0.2ml) of the Pfizer-BioNTech vaccine.

“Syringes supplied by China to administer Sinovac-CoronaVac Covid-19 vaccine had primary measurement-line marking of 0.2 ml, which allowed us to administer the vaccine to children between five and 11 years old,” said Bade Babu Thapa, an official at the Logistic Management Section under the Department of Health Services.

“We have somehow managed to administer the second doses to 5-11 year olds in many districts, but children in some districts have yet to get their second doses owing to a syringe shortage.”

Officials said the COVAX facility, the United Nations-backed international vaccine sharing scheme, has to supply syringes along with the vaccine doses.

Around 2.2 million children of the said age group in 27 districts were inoculated with paediatric doses of the Pfizer-BioNTech vaccine in the first phase of the campaign launched on June 23.

The 27 districts where the first phase of the campaign was launched include Jhapa, Ilam, Morang, Sunsari, Saptari, Dhanusha, Parsa, Siraha, Mahottari, Kathmandu, Lalitpur, Bhaktapur, Chitwan, Kavrepalanchok, Sindhuli, Makawanpur, Kaski, Nawalparasi West and Nawalparasi East.

Other districts where vaccination drives have been planned in the first phase are

Rupandehi, Banke, Dang, Bardiya, Surkhet, Kailali, Kanchanpur, and Dadeldhura.

In some districts, the first dose vaccination was halted due to a lack of vaccine doses, and the second dose vaccination, which was to start after 21 days, was delayed due to syringe shortage in some districts including in the districts of Kathmandu Valley.

Administration of booster doses to children and adolescents between 12 and 17 years was also affected in some districts including in Kathmandu Valley due to a shortage of syringes.

Earlier in December last year, Covid vaccination for 12-17 year olds with the Pfizer-BioNTech vaccine was halted owing to a syringe shortage.

The Health Ministry plans to launch the second phase of the campaign from August 21 to 27 in the remaining 50 districts.

Officials, however, said that the schedule of the second phase of the drive could be affected if the United Nations-backed vaccine sharing scheme failed to deliver the doses on time.

“We managed to administer second doses to children between five and 11 years with the syringes provided by China even though we had to improvise,” said an official at the Department of Health Services, asking not to be named. “But we don’t have syringes for the second phase of vaccination.”

Two types of syringes are needed to administer a paediatric dose of the Pfizer-BioNTech vaccine—a 0.2ml syringe for vaccine administration and a 2ml syringe for vaccine mix-up with diluent.

The Pfizer-BioNTech vaccine for adults is administered through a 0.3 ml syringe, health officials say, while for other vaccines, a 0.5ml auto-disable syringe is used.

Officials at the Logistic Management Section informed that COVAX has recently supplied 2.4 million syringes but has not supplied the syringes needed for mixing the vaccine with diluent.

“We are in regular touch with officials from the Global Alliance for Vaccine and Immunisation and have drawn their attention for syringe supply,” said Sagar Dahal, chief of the National Immunisation Programme. “We hope that they will supply us with the syringes on time for the second phase of the immunisation campaign.”

Officials at the Health Ministry said that agencies under the Nepal government are equally responsible for the syringe shortage.

“The Ministry of Finance, Health Ministry and Office of the Prime Minister and Council of Ministers took so much time to make tax waiver arrangements for the syringes to be provided by COVAX,” an official at Health Ministry told the Post asking not to be named, as he is not authorised to speak to media on the matter. “The COVAX facility did not send the consignment without a tax waiver file, which caused delays in the shipment of syringes.”

Around 2.4 million children between five and 11 years old from 50 districts will be inoculated with the Covid-19 vaccine in the second phase of the vaccination campaign.

Nepal has so far received 58,891,970 doses of Covid vaccines of various brands—AstraZeneca, Vero Cell, Moderna, Janssen, Sinovac-CoronaVac, and Pfizer-BioNtech—including those of paediatric doses.

So far, 20,579,365 people or 70.5 percent of the total population have been fully immunised.

On Sunday, one person died and 620 others tested positive for Covid—496 in 2,551 polymerase chain reaction tests and 124 in 3,195 antigen tests.

The Health Ministry said that 33 infected people in serious conditions have been admitted to intensive care units and five have been placed on ventilators at various hospitals.

Active Covid cases stand at 4,567 throughout the country.

Arjun Poudel is a health reporter for The Kathmandu Post. Before joining the Post, he worked for Sagarmatha Television, Naya Patrika, Republica and The Himalayan Times.