While each vial was to initially contain five doses of the vaccine, the medical giant started to charge its client countries more after the European Medicines Agency announced that a sixth dose can be extracted with the correct type of needle.

Sweden has decided to put payments to the pharmaceutical company Pfizer on hold until the issue of vaccine dosage is clarified, the newspaper Dagens Nyheter reported.

When the EU first approved Pfizer’s COVID-19 vaccine, each vial was to contain five doses. However, after the European Medicines Agency announced that a sixth dose can be extracted with the correct type of needle, the company started charging for six doses per vial.

“It is unacceptable. If a country only has the opportunity to take out five doses, then it has received fewer doses at the same price”, Sweden’s vaccine coordinator Richard Bergström told the newspaper.

Until the issue of dosage per vial is settled, the Swedish Public Health Agency has decided to ignore the bills from Pfizer. Instead, the country intends to wait for a joint EU solution.

“What invoices they have sent and what they look like, doesn’t really matter at the moment, we have said that we have to wait for a message from the EU about what really applies”, state epidemiologist Anders Tegnell said.

The increased invoicing has been taking place without approval from the European Commission.

“Since the approval of the sixth dose, we start from that number. We must comply with the approved product regulations”, communications manager for Pfizer Sweden Ulrika Goossens told the newspaper.

In an interview with national broadcaster SVT, Goossens admitted that it can be a “challenge” to get the sixth dose out and assured that the company is “carrying out tests of different combinations of needles and syringes” and keeps updating its clientele on its website about the optimal choice.

At the turn of the year, Sweden secured 6.7 million vaccine doses from Pfizer and BioNtech, according to Minister of Trade and Industry Ibrahim Baylan. This is enough to vaccinate 3.35 million people in a nation of over 10 million, as two doses per person are needed.

In mid-January, however, Pfizer announced it will reduce the number of doses delivered to Europe, citing an upgrade of production technology. So far, Sweden has received a little over 170,000 doses.

Swedish Minister of Social Affairs Lena Hallengren called the delay and shortages “unacceptable’, penning a joint letter with fellow ministers from Denmark, Estonia, Finland, Latvia, and Lithuania to voice great concern that the lower volumes reduce the credibility of the vaccination programme.

So far, Sweden has been the most-hit Scandinavian nation, with over 550,000 COVID-19 cases and over 11,200 lethal outcomes – more than its Nordic peers combined.