Preparing Comirnaty adults and adolescents syringes in Trusts

Ian Allen, Pharmacy Quality Assurance Regional Specialist (NW), North West Pharmaceutical Quality AssurancePublished Last updated See all updates

Comirnaty concentrate for adults and adolescents preparation resources are provided including standard operating procedures, work instructions and a checklist.

Change of needle sizes · Needles for reconstitution and preparation are changing size in 2022

Further details are provided below. Vaccination sites should be aware but do not need to take additional actions.


Attached to this page are:

  • A standard operating procedure describing preparation of the vaccine
  • A preparation work instruction sheet for the vaccine
  • A supervision checklist for preparation of the vaccine

Changes to needles in 2022

The needles that are supplied for reconstitution and preparation of syringes will change in early 2022.

Old needle sizes

The old needle sizes, which are included in our SOPs, use a 21 gauge needle for reconstitution and 23 gauge needles for preparation of syringes for administration.

New needle sizes

In early 2022, UKHSA will be providing 23 gauge needles for reconstitution and 25 gauge needles for preparation of syringes.

Timelines and action

The change will be gradual: some vaccination centres will receive the new syringes and needles before our SOPs are updated; others will continue to stock the previous syringes and needles after the SOPs have been updated.

Vaccination centres do not need to take any specific action. They should continue to use the needles and syringes provided by UKHSA, using original stock first.


The attachment is presented in Word to enable adaptation locally, or as reference source to check that existing local procedures are robust and comprehensive.
Within the SOP:

  • GREEN TEXT indicates that detail is awaited, and will be added when available;
  • RED TEXT indicates where detail is to be added locally.


Other handling content for Trusts

Other COVID-19 vaccines resources

External Resources to Support Preperation

What to do if you still have questions

If you still have questions you can get in touch with us. However, please first read our service remit; and if you still think we can help, use the email address below.

We're supporting healthcare professionals in England with pharmaceutical aspects of the COVID-19 vaccination programme; read our service remit to find out more.
If you're a healthcare professional who needs further advice, get in touch with us. We answer questions about Medicines Optimisation issues, including those about the COVID-19 vaccination programme. Help us to help you: tell us where on our site you were.

Change history

  1. Changed throughout to include Children 5-11 years product. Removal of reference to Regulation 174 product.
  1. Text added on changes to needles
  1. Banner added on changes to needles
  1. Additional detail on need to undertake gradual pressure equalisation if using an auto retracting needle. Additional detail on technique to reduce coring. Use of 2mL or 3mL syringe for dilution added to reflect new syringes supplied
  1. Updated to reflect availability of Comirnaty & associated changes
  1. VH8 Amended instructions for disposal of cartons to include placing in confidential waste
  1. VH8, VH8.1 and VH8.2 updated to describe withdrawal of 6 doses as standard practice
  1. VH8 Section 2 updated to include model of one person diluting and drawing up
  2. VH8 4.4.4 Now states “new” syringe / needle must be used
  3. VH8 4.4.1, VH8.1 and VH8.2 updated to include additional references to 6th dose
  4. VH8 4.1.7 addition of 2nd check to include correct vaccine vial selected
  1. Change to SOP VH8 Section 4.3.4, regarding presence of opaque particles prior to dilution
  2. VH8.1 updated to reflect the change
  1. Published