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Queensland vaccination update – ultra-low dose given to six patients

11 August 2021

Queensland Health has today contacted 66 people who received the Pfizer COVID-19 vaccination at Kippa Ring Vaccination Centre before 9.30am on Saturday 7 August. It has been identified that six people may have received an ultra-low dose of the vaccine, due to a vaccine administration error.

The Pfizer vaccine requires a process of preparation, where saline is added to the vaccine vial and withdrawn to make up to 6 syringes. An initial review indicated one vial was used twice, meaning the doses drawn on the second use were over-diluted. The error occurred within the first hour and a half of the clinic opening and immediate action was taken. Unfortunately there is no ability to trace which six of the first 66 patients through the vaccination clinic were given the ultra-low dose.

An official review has occurred to further understand what happened, what caused the error and how processes can be improved.

Chief Health Officer Dr Jeannette Young said an ultra-low dose is not harmful, but could affect your immunity to COVID-19.

“We are working with those impacted to ensure optimal immune response to the vaccination is achieved,” Dr Young said.

“Of those 66, 26 were receiving their first dose and 40 were receiving their second dose.

“Those affected will be offered a new appointment to receive a repeat dose to ensure they are fully vaccinated against COVID-19.

“There is no clinical risk associated with receiving a third dose of Pfizer.”

Queensland Health has attempted to make phone and email contact with each of the 66 persons. Those who attended the Kippa Ring Vaccination Centre and were vaccinated at or after 9.30am on Saturday 7 August, or on another date, are not impacted and do not need to take any action.

Metro North Hospital and Health Service Acting Chief Executive Jackie Hanson apologised for the error and said it was detected early on in the day as part of the due diligence process.

“I am incredibly sorry for any distress this has caused to those 66 people and their families. We will, of course, be supporting every single person impacted,” Ms Hanson said.

“I am incredibly grateful we have good safety culture at Metro North and that the error was picked up quickly as a result of those safeguards.

“I have received a full incident report which will allow me and my staff to better understand what needs to be done to improve our processes.”


Last updated: 11 August 2021