– Very troublesome – VG

– We believe that it is very problematic that we cannot use all the content of the vials, when deliveries to the municipality are low. Many of our residents are concerned and frustrated by this, says City Manager Grete Syrdal in Bærum Municipality.

VG wrote on Monday about Tromsø, which feels compelled to discard vaccine doses after FHI updated its vaccine guide before the weekend, emphasizing that withdrawing more than six doses of Pfizer, or more than 10 doses of AstraZeneca and Modern, is “off label.” It must be approved by the responsible physician, who is then “responsible for the consequences of such use.”

The municipality of Bærum has experienced that it is possible to withdraw more than six doses from Pfizer cups, but will now adhere to these guidelines, according to Syrdal.

This means that the seventh dose of Pfizer that can be taken out of the glass is thrown away; the same applies to the 11th or 12th dose of AstraZeneca.

Denmark has long had a national recommendation to take up to seven doses from Pfizer cups, and the Finnish Institute of Public Health recently issued instructions for a new method on how to do it.

– Safe to continue

The Kristiansand Municipality has carried out another assessment. They have a routine that all doses can be used, which is approved by the infection control doctor in a group meeting, according to Per Vassbotn, leader of the vaccine group.

– But it is not the case that we remove seven doses from all vials.

He says that GPs have been informed that it is not indicated on the label and that they can do their own evaluation.

– The GP representative believes that it is safe to continue with the existing practice and that he is confident that the doses are not too small. We ask that you do not stop with the routines that work well in the individual medical center and that ensure good use of vaccines.

In Oslo, the infection control doctor has decided that the seventh dose can be used if a full dose can be obtained, says the Health Agency.

Stavanger: It’s risky to have a seven-dose practice

The Municipality of Stavanger has always followed the FHI line of preparing six doses of Pfizer and ten doses of AstraZeneca, even before FHI submitted a clarification.

But if he still manages to recall a seventh dose of Pfizer, the doctor at the vaccination center can decide whether it should be used, according to infection control chief Ruth Midtgarden.

This is if the vaccinated person is expected to also receive a dose of two. Midtgarden also doesn’t want to push for the seventh dose, which they think may lead to setting doses that are too small:

– If we say that you should try to receive seven doses, we run the risk of receiving smaller doses than others. Therefore, as a responsible municipal chief physician in a large municipality, I want to follow the FHI line, he says.

Drammen sticks to six doses of Pfizer, but chooses to take eleven Astrazeneca. Trondheim does the same.

Put this on?

Has stayed at six

The Municipality of Asker changed its practice and stopped taking eleven doses of AstraZeneca after the FHI clarification before the weekend.

At the same time, they have chosen to the end, even before the updated FHI guidelines, to follow six doses of Pfizer.

– We think the seventh dose is difficult anyway. We got six from Pfizer and ten doses from AstraZeneca, says City Chief Physician Meera Grepp, adding:

– I think it can wrinkle with vaccine number two, then you have to take seven too.

The Bergen Municipality claims they have followed FHI’s recommendations and had the practice of taking six doses out of the Pfizer cups and not using the leftovers in the cup. The exception is the Bergen emergency room, which has recalled seven doses when employees have been vaccinated.

FHI: can use dose seven

– Bærum and other municipalities can use all the content. “Off label” does not mean that this is prohibited. If they want and can extract more doses than the manufacturer itself has defined, they must be approved by the responsible physician, says director of infection control Geir Bukholm of FHI to VG.

He believes that nothing prevents the municipality from spending more, if approved by a doctor:

– The only limitation that Bærum and other municipalities that want to do this have is that such “off-label” use must be approved by the responsible doctor. If the responsible physician approves the use of dose seven, municipalities can use dose seven.

Steinar Madsen of the Norwegian Medicines Agency has previously explained that “off-label” use is allowed in Norway, and that it includes all conditions that do not conform to a prescription review, from number of doses to the method, to whom medicine is used.