Copley Hospital nurses are used to administering shots, but perhaps none has been as momentous as the 125 doses of the Pfizer COVID-19 vaccine given out to hospital staff last week.
Donna Bernardino, a Copley phlebotomist, said she was nervous and excited the night before, recognizing the historical nature of being among the first wave of people in the country to get vaccinated against a global disease that has been attributed to more than 300,000 American deaths in nine months. She said 20, 30 years down the road, people will look back at this as a historical moment.
“We’ll tell our grandkids,” she said. It feels like the beginning of the end, in a good way.”
The 125 people inoculated at Copley last Wednesday were all given the Pfizer/BioNTech vaccine, according to Dr. Don Dupuis, the hospital’s chief medical officer. Dupuis said a second vaccine manufactured by Moderna is expected soon, and is likely to be one most on hand at Copley as more vaccinations are rolled out.
Both vaccines use similar science, and are touted as 95 percent effective against coronavirus.
“Efficacious, safe and perhaps mildly unpleasant,” is how Dupuis explained it.
After receiving the shot, patients sit in a different area, eating cookies beneath their masks, waiting to see if they have any adverse reactions, both the “perhaps mildly unpleasant” side effects but also any more serious allergic reactions.
Reactions, such as anaphylaxis — think peanuts or bee stings — are said to be rare, although they have been documented in some patients. As a precaution, medical staff keep an EpiPen on hand.
Recordkeeping is key to making sure a person receives the correct second dose at the correct time, and “to make it extra complicated,” the two vaccines follow different schedules, Dupuis said — Pfizer has a three-week gap between the first and second shots; Moderna has a four-week gap.
He said patients need to have two shots to make the vaccine fully effective, but even just the first one provides some protection against COVID-19.
When a patient receives the first inoculation, their second dose is already wired in, and they just have to wait the assigned time period.
He marveled at the messenger RNA technology behind the Pfizer and Moderna vaccines, the latter of which is made in Cambridge, Mass.
“It’s brand spanking new,” he said. “It’s just a miracle that they could both make it work and they could make it work so fast and do the study so people can have confidence in it.”
Much has been made about the difficulty in storing the vaccine, especially Pfizer’s, which has to be kept at nearly 100 degrees below zero, Fahrenheit. Moderna says its vaccine can be stored at normal freezer temperatures.
To make transportation from the manufacturer to the hospital or pharmacy possible, Pfizer designed a special container that keeps the vaccine at the requisite deep freeze. Larger hospitals, such as UVM Medical Center, will receive full pallets of the vaccine, about 975 doses, and can keep it on hand longer, until it’s opened.
Smaller places like Copley receive fewer doses, so they have to be “broken off” from the original, and the hospital has only 125 hours to use it. It’s just a coincidence that Copley had 125 doses for the first round; any amount outside a full pallet has to be used quickly, Dupuis said.
“As soon as you open it, the clock starts ticking,” he said.
The hospital received the vaccines on ice Tuesday night, and had it stored in mini-fridges in the health center inoculation room. Another time-sensitive variable: once the medical staff “reconstitutes” the vaccine with saline solution, they have six hours to use that vial.
“It’ll hang out at vaccination strength for six hours before fading away,” Dupuis said.
Another reason Dupuis favors the Moderna vaccine is that Moderna will ship that vaccine directly, and in 100-dose containers, a more manageable amount that doesn’t have to be broken off from a larger package.
Copley will be a hub for area medical workers throughout Phase 1 of the vaccine rollout — not just its own staff but EMS crews, home health doctors, anyone in close medical contact with people. Copley employs about 490 people, but there was something of a priority with those first 125 doses.
So, the people with the most direct patient contact — emergency department nurses and doctors, phlebotomists (the folks who draw blood), radiologists, and the like — got it first. Travis Knapp, Copley’s director of anesthesiology, was the first person at the hospital to get the vaccine last week.
Folks like Dupuis, who oversees them all but doesn’t have the direct patient contact, got his after them.
Also included in Phase 1A are residents and staff at nursing homes. The Manor, right across the street from Copley, was scheduled to receive its vaccinations this Wednesday, Dec. 23. Pharmacies, not hospitals, have the contract to administer doses in these long-term care facilities.
Health care leaders emphasize that the vaccine isn’t a magic bullet that will make the coronavirus go away, and it will be several months before the general public is inoculated, according to Jeff Tieman, president and CEO of the Vermont Association of Hospitals and Health Systems.
“While we can finally see the possibility of a return to a more regular life, that time is not now,” Tieman said in a statement last week. “Even the people who will get their vaccinations today must continue the drill — masks on faces, six-foot spaces, uncrowded places — until enough people receive the vaccine to stop it from spreading.”
In some ways, right now, it’s business as usual, Dupuis said — professionals doing their jobs. He said he and Copley CEO Joe Woodin were hanging out at the loading dock Tuesday night, waiting excitedly for the delivery of the first 125 doses.
“Considering how momentous the delivery of the vaccine is, you were expecting something like V-E Day, maybe not fireworks but certainly there would be quite a bit of ceremony,” he said. “But, really, it was a just a guy coming up with a box, and he opens it, take some things out and we take it in and put it in a refrigerator. That’s all we did.”