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| Thursday, Dec 24, 2020
Vaccine
Pharmacist, Courtney Mattley displays a vile of the Pfizer BioNTech, Covid-19 vaccine before administering the first dose at Henry Mayo Newhall Hospital in Valencia on Thursday, 121720. Dan Watson/The Signal

 

The morning journey for one of the most anticipated trips in the Santa Clarita Valley since the onset of the coronavirus pandemic — the delivery of the first freezing cold batch of Pfizer-BioNTech COVID-19 vaccines — began with a typically SoCal experience for the pharmacist in charge of bringing the 1,400 highly sought-after doses to the SCV: an Interstate 5 SigAlert.

“I woke up to pick up the vaccines and I had three text messages from executives on our team saying, ‘Did you see the SigAlert?’” said Carissa Bortugno, a registered pharmacist and senior director of clinical support services at Henry Mayo Newhall Hospital, referring to the morning of Dec. 17.

Bortugno doesn’t usually receive multiple traffic alerts from Henry Mayo executives regarding her morning commute. But that Thursday was a little different.

A shipment of 1,400 Pfizer vaccines set for Henry Mayo’s frontline workers sat in an ultra-low freezer at Olive View-UCLA Medical Center in Sylmar that morning, waiting for pickup for distribution at the local hospital, which was scheduled to happen by noon that day.

The text messages cautioned of a jackknifed big rig and fuel spill in the southbound lanes of I-5, near the Newhall Pass — the path she planned to take to Olive View.

“We had ice and everything to be prepared, but we were concerned about getting stuck in traffic — because you don’t want to be stuck on the freeway with all these vaccines on the first day of pickup, on the day we were scheduled to give 300 vaccines,” she said.

With quick planning, the team found an alternative route via Highway 14 and arrived at Olive View, with the clock ticking for those waiting at Henry Mayo, which only had five days to use every dose before the vaccines expired “because it was out of the ultra-low freezer,” said Bortugno. The Pfizer vaccine needs to be kept in minus 94 degrees Fahrenheit — colder than winter in Antarctica — to help prevent the doses from spoiling.

By noon, however, Courtney Mattley, a clinical coordinator of pharmacy at Henry Mayo, had successfully administered the first shot to Kathy Brady, a senior clinical registered nurse in the hospital’s intensive care unit.

The “huge undertaking,” as Bortugno called it — administering more than 1,400 doses in less than five days with the help of even medical volunteers and nursing and pharmacy school students — was underway.

Reactions to the first rollout
In a recent Henry Mayo survey, officials found that between 70% to 80% of their frontline workers indicated they planned to get vaccinated.

Bortugno and Sarah Stoddard, a registered nurse and in clinical informatics at Henry Mayo, said that on day one of the vaccine rollout, there was some hesitation. On the second day, more people became comfortable after some of their colleagues had received it and, by day three, there was an overwhelming sense of relief as more people took the vaccine.

Some who received the vaccine did experience some side effects, such as redness and soreness, and a few people reported low-grade fever and muscle ache — adverse events typically seen in other vaccines. One person had a severe adverse reaction initially but was treated promptly, and has recovered from their home, according to Bortugno and Stoddard.

Executing the first wave of vaccines
Henry Mayo received enough vials to administer 1,400 vaccines, about five doses for each of the 280 vials — but Food and Drug Administration officials later announced some vials could contain up to seven doses.

“Interestingly enough, you can get more doses per Pfizer vial,” said Bortugno. “We have administered 1,606 (from the 1,400). In the first bit, we did see six to seven per vial; however, it just depended on the needle size and, toward the end, we just saw five to six doses.”

“We did get extras but there was not a single drop that was wasted,” added Stoddard.

Both vaccines from Pfizer-BioNTech and Moderna, which the FDA authorized for emergency use on Dec. 18, require two doses per person, each within a span of 21 to 28 days.

Breaking down the logistics
To date, Henry Mayo has finished its first batch of vaccines and has inoculated about half of its staff, according to hospital spokesman Patrick Moody. With thousands of personnel to keep track of for doses, the task required efficiency and significant data entry.

“There are a lot of Excel spreadsheets,” Stoddard said with a laugh. “This does require an exhausting amount of coordination. There are two sides to this: How do we monitor who comes in and needs the vaccine, and how do we organize all the staff to support that.”

Stoddard said the hospital didn’t have a template or guide for how to manage such a massive vaccination effort, but communication was key.

“We have a great group that’s handling just the logistics,” said Stoddard, adding that the vaccine does come with a database to help track vaccinations. “We will be using that data from our system to keep a record of our employees and to ensure that they have all the right information.”

What comes next?
The hospital is already preparing for its second wave of Pfizer vaccines to complete the inoculation of its personnel, a move that falls under the state’s phase 1A to vaccinate health care workers first. Phase 1B will include those 75 years or older and other frontline workers, such as first responders, teachers, and food and agricultural workers. The following phase will include those with significant underlying health conditions.

On Wednesday, the U.S. Department of Health and Human Services announced it had reached a deal with Pfizer to buy an additional 100 million COVID-19 vaccines, of which 70 million could be delivered by the end of June.

Henry Mayo is not expecting to receive the Moderna vaccine, however, as the hospital is able to handle the temperatures needed to store the Pfizer vaccine, which is stored at minus 94 degrees. Outpatient pharmacies, such as CVS, are expected to have Moderna as they can store the vaccine in higher temperatures of minus 4 degrees, according to Bortugno.

Moderna most likely will be the one rolled out communitywide. Once available on a more widespread level, both vaccines are expected to be offered at no cost, she added.

“Community vaccination could be somewhere around early summer,” said Bortugno.

Vaccination Begins at Henry Mayo

Pharmacist, Courtney Mattley, left, administers the first dose of Pfizer BioNTech, Covid-19 vaccine to Intensive Care Unity nurse Kathy Brady at Henry Mayo Newhall Hospital in Valencia on Thursday, 121720. Dan Watson/The Signal

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