Urgent action needed now to ensure sufficient COVID vaccine syringe supply to meet 2022 vaccination targets 

Increased demand, supply chain disruptions, and ‘syringe nationalism’ could lead to significant challenges in 2022 without immediate action

27 October 2021
India. A health worker prepares a dose of the Covid-19 vaccine at a dispensary in Guwahati on April 29, 2021.
A health worker prepares a dose of the Covid-19 vaccine at a dispensary in Guwahati on 29 April, 2021.

Statement by UNICEF Executive Director Henrietta Fore

NEW YORK, 27 OCTOBER 2021 – “Without action now, the world could face a serious shortage of COVID vaccine syringes by the end of 2022, with potentially dire consequences for the global effort to bring the pandemic under control.

“Last month, supporters of the global effort to provide access to COVID-19 vaccines aligned around a new target during the Vaccine Summit held on the margins of the UN General Assembly: Vaccinating at least 70 per cent of the population in every country against COVID by 2022. This ambitious aim intends to deliver on the promise of more equal access to COVID-19 vaccines.

“However, as we collectively ramp up access to COVID-19 vaccines, we must equally ramp up access to the syringes needed to administer them.

“Working closely with partners, UNICEF has been leading the charge. We tripled the number of syringes ordered to meet demand – securing almost 3 billion auto-disable syringes since 2020, including the creation of a GAVI-funded stockpile of half a billion syringes to prepare for the COVID-19 vaccine rollout.

“Thus far, this supply has been sufficient to meet the increased needs for syringes sourced via UNICEF. However, to reach the new COVID-19 vaccination targets, and assuming an unhindered vaccine supply next year, there could be a shortfall of up to 2.2 billion auto-disable syringes, according to UNICEF projections. This shortage would only hit the type of syringes that lock automatically to prevent reuse, as required by WHO and UNICEF guidelines. Low- and middle-income countries – where this type of syringe is critical for safety – will bear the brunt of this shortage. We are not anticipating a significant supply shortage of the more standard syringes used in high-income countries.

“The anticipated shortfall is the result of the significantly higher demand, disruptions to international freight and supply chains, an unpredictable supply of vaccines due to a significant reliance on much needed donated doses, and national bans on syringe exports.

 “To avert this scenario, we need six urgent, but achievable, actions:

  • Expanded access to supply, both of standard 0.5ml auto-disable syringes used for most COVID-19 vaccines and for routine immunization, and 0.3ml syringes used for the Pfizer-BioNTech COVID-19 vaccine. This will necessarily require increased production by manufacturers of relevant and quality-assured products.
  • A more secure and predictable supply of COVID-19 vaccines to allow us to make best use of limited syringe supply.
  • The prioritization of injection equipment shipments by international freight carriers similar to the prioritization of vaccine shipments.
  • An end to ‘syringe nationalism’ and the hoarding of desperately needed safe injection equipment.
  • A review of the plans and timing of local immunization campaigns, as well as the phasing of local COVID-19 vaccination rollouts, so that the public health impact of global immunization campaigns can be optimized, and global syringe supply can be best utilized without significantly impacting critical immunization efforts worldwide.
  • The consideration of expanded use of alternative quality-assured reuse prevention (RUP) syringes as the next best alternative to auto-disable syringes, in line with the national policy of the recipient countries based on WHO/UNICEF guidelines. 

“We are working with key partners – including the United States, COVAX, PATH, donors, syringe manufacturers and others – to take the necessary action to address the situation, and will continue to monitor progress. We are working to get the most out of our existing arrangements and to sign new agreements with syringe suppliers that are able to step up to the challenge in 2022.

“We are grateful to our partners for their support and efforts to meet this critical supply challenge.

“We call on governments, manufacturers and organizations involved in the global COVID-19 vaccination effort to work together on this common challenge, with a shared understanding that if we take these simple steps there will be enough syringes to meet the world’s needs.

“An ounce of prevention is worth a pound of cure. Together, we can prevent today’s solvable challenge from becoming next year’s intractable one.”


Notes to Editors

The projected shortfall is based on UNICEF market estimates of syringe supply. It is theoretical and assumes that COVAX calls its options, that vaccine supply is unhindered in 2022, and that countries are able to absorb doses. The shortfall could be smaller if countries demand fewer doses and, thus, fewer syringes.


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