Hospitals and medical centers spent Sunday preparing for the first COVID-19 vaccine to arrive Monday morning, a massive undertaking that began when a caravan of semis guarded by unmarked police cars pulled out of the Pfizer manufacturing plant in Portage, Michigan, just after dawn.
Onlookers applauded and cheered as the tractor-trailers carrying 189 boxes of vaccine slowly rolled out. The doses held in those cartons will be injected into the arms of health care workers in all 50 states beginning Monday morning.
The U.S. Food and Drug Administration authorized the first vaccine to prevent the disease Friday night. Developed by Pfizer and its German partner BioNTech, the vaccine appears to be extremely safe and highly effective – and brings the hope of an end to the pandemic.
“We have millions of doses of this vaccine that are now being shipped to every corner of America, with administration to begin as soon as providers are ready,” said Secretary of Health and Human Services Alex Azar.
Those providers spent the weekend running through every possible contingency that could get in the way, from earthquakes to power outages.
“We did our final run-through exercise today,” said Dr. Nasim Afsar, chief operating officer for UCI Health in Irvine, California. The team role-played the entire process, from vaccine arriving at the loading dock to an injection being given.
“One person would say, ‘I’ve got the vaccine, I’m walking to the clinic. This is the path I’m going to take.’ And then another would be a sample patient and someone would bring them into the room and we’d walk through the entire process of getting them vaccinated,” she said.
Health care workers and nursing home residents will get the vaccine first. More doses will be rolled out in the weeks and months to come. A similar COVID-19 vaccine, developed by the Massachusetts-based biotech Moderna, will go through the same review process this week and could be cleared for use by the weekend.
Pfizer and BioNTech are expected to deliver 100 million doses of their vaccine by the middle of next year; Moderna pledged 200 million doses by then.
Afsar’s team was one of hundreds nationwide putting the finishing touches on plans months in the making. This week, they hope, will mark the beginning of the end of the coronavirus pandemic that has ravaged the world, and especially the USA.
America is closing in on 300,000 dead. As of last week, about 1 in 8 U.S. hospitals had little or no intensive care unit space available, and experts said the number of hospitals struggling to accommodate the nation’s sickest patients probably will increase after another week of record COVID-19 cases.
“This is not only going to save lives, this is going to take away fear. There just aren’t words for what this means,” said Dr. Gregory Poland, director of the Mayo Vaccine Research Group and editor-in-chief of the journal Vaccine.
Precise planning will ensure full use of ‘every dose’ of vaccine
The run-throughs and tabletop exercises and hours and hours of Zoom calls are necessary because dealing with the Pfizer vaccine takes training and great organization.
Once the vials of vaccine arrive, they must be immediately placed in ultra-cold freezers to be kept at below minus 94 degrees.
“We’ve got a detailed plan for when it arrives, involving our public safety staff and our police force. It will be stored in a badge-access-only space with cameras and will be monitored 24/7,” Afsar said.
To give shots, a very precise protocol must be followed. A vial of the vaccine concentrate must be thawed for two to three hours in a refrigerator or at room temperature for 30 minutes.
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Then a precise amount of a saline solution must be mixed into the vial to reconstitute it. The vial is gently rocked to mix the two. When ready, the vaccine can be drawn up into syringes, five doses to a vial.
There are strict time requirements. Once mixed, the vaccine is good for only six hours, then must be discarded.
“We’ve worked out an assembly line, one person preparing the vaccine and tracking timing, another actually giving the shots,” said Tiffany Tate, executive director of the Maryland Partnership for Prevention, a nonprofit group that supports the state’s immunization coalitions.
“You don’t want the person giving the shot to be the one with the stopwatch monitoring how long each batch has been out. It’s not efficient, and we need to be efficient,” she said.
Sunday, UCI Health tested a text notification system to avoid doses being wasted. As health care workers are vaccinated, if it looks like there may be more doses than people waiting for shots, they’ll send a text to the next staffers on the waiting list.
“It will be first-come, first-served for that final small group. We want to make sure we fully use every dose we’ve got,” Afsar said.
They’ve planned for fires, power outages, earthquakes and other things so bad Afsar didn’t want to mention for fear of giving anyone ideas.
“We’ve tried to poke holes in every scenario, so we have backup plans for everything,” she said.
Pfizer, Moderna vaccines will begin ‘bending the curve’
Monday’s 189 boxes of vaccine are just the start. Over the next three days, Pfizer will ship upward of 680 boxes. That’s for the first week. The entire process will begin again the following week with even more doses, Army Gen. Gustave Perna said Saturday. Perna heads Operation Warp Speed, the government’s vaccine development and distribution effort.
The Pfizer vaccine and the anticipated Moderna vaccine require two shots, given 21 to 28 days apart.
Expressing unusual emotion, normally matter-of-fact doctors said the boxes arriving at loading docks and clinic doors over the next three days represent hope.
Robert Wachter, chairman of the Department of Medicine at the University of California-San Francisco, said he feels relief, but it’s tempered with exhaustion and sadness.
“It will be a few months before the vaccines really contribute to bending the curve – and by that time, another 200,000 Americans will be dead,” he said.
Still, had there been no vaccine, it would have been so much worse.
“If we do nothing and continue the way we are, by the end of March, one out of 700 Americans will have died of COVID,” Poland said.
The medical science that stands poised to vanquish the virus is nothing short of breathtaking, said Dr. Kelly Moore, associate director of immunization education with the Immunization Action Coalition.
After months of work in the lab, the baton is being passed from vaccine developers to public health leaders to finish the race to end the pandemic.
More funding will be needed, she said, so officials can plan vaccination programs to make sure those most in need are reached no matter where they live.
“Our goal,” Moore said, “is for the pace of vaccination to be limited only by the supply of vaccine.”
Contributing: Karen Weintraub, Ken Alltucker and Aleszu Bajak, USA TODAY; Nicole Avery Nichols, Detroit Free Press; and Lucas Aulbach, Louisville Courier Journal
This article originally appeared on USA TODAY: Role-playing, planning for earthquakes, mass training: US health care centers prep for arrival of COVID-19 vaccine