The Ministry of National Health Services, Regulations and Coordination on Tuesday issued interim guidelines for Pfizer-BioNTech Vaccine’s storage, handling, administration and safe disposal along with recommendations for vaccine recipients. Sharing details of the guidelines an official of the ministry said that the vaccines are an important part of strategies to curtail the devastating Covid-19 pandemic in the country. He said the Pfizer vaccine needed special handling to maintain its effectiveness while safe transportation, storage, administration, and disposal of vaccine waste must be ensured at all vaccination facilities. He said as per guidelines individuals aged 18 years and older who were clinically extremely vulnerable (CEV) being at a high risk of severe illness from Covid-19, who have not received other currently available Covid-19 vaccines are eligible for Pfizer-BioNTech vaccine. He added those who should receive the vaccine included Solid Organ Transplant (SOT) recipients and pre-transplant patients with a complete vaccine course at least two weeks prior to transplantation if possible. He said that post-transplant patients may receive vaccine one month after transplantation while no adjustment of immunosuppressive medications are required prior to vaccination besides Hematopoietic Stem Cell Transplant (HSCT) recipients and those being planned for HSCT. Those suffering from Primary Immune Deficiency Diseases (PIDDS) are also eligible like Immunosuppression due to disease or treatment, including patients undergoing chemotherapy leading to immunosuppression, patients undergoing radical radiotherapy, HIV infection at all stages and multiple myeloma. He added that individuals are also eligible who are receiving immunosuppressive or immunomodulating biological therapy including but not limited to, anti-TNF, alemtuzumab, ofatumumab, rituximab, patients receiving protein kinase inhibitors or PARP inhibitors, and individuals treated with steroid-sparing agents such as cyclophosphamide and mycophenolate mofetil. Similarly, this vaccine is allowed to individuals treated with or likely to be treated with systemic steroids for more than a month at a dose equivalent to Prednisolone at 20mg or more per day for adults (if they have not received other currently available vaccines). Anyone with a history of haematological malignancy, including leukaemia, lymphoma, and myeloma and those with systemic lupus erythematosus and rheumatoid arthritis, and psoriasis who may require long-term immunosuppressive treatments are also eligible. Use of this vaccine is also allowed to Asplenia or dysfunction of the spleen. This also included conditions that may lead to splenic dysfunction, such as homozygous sickle cell disease, thalassemia major and coeliac syndrome. Other severe chronic conditions where Pfizer-BioNTech vaccine may be recommended by the treating physician, including chronic respiratory disease with individuals with a severe lung condition, including those with asthma that requires continuous or repeated use of systemic steroids or with previous exacerbations requiring hospital admission, and chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema, bronchiectasis, cystic fibrosis, interstitial lung fibrosis, pneumoconiosis and bronchopulmonary dysplasia (BPD). The vaccine is allowed for patients with chronic heart disease and vascular disease including congenital heart disease, hypertension with cardiac complications, chronic heart failure, individuals requiring regular medication or follow-up for ischemic heart disease. This included individuals with atrial fibrillation, peripheral vascular disease or a history of venous thromboembolism.