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As the first American healthcare professional I rolled up my sleeves In the case of the COVID-19 vaccine, the images were instantly frozen in history, demonstrating the victory of scientific know-how and ingenuity. The camera shot the first truck pulled from a warehouse in Portage, Michigan, and was applauded by workers and locals. The next day, Boston Medical Center employees (some dressed in scrubs, wearing masks, face shields, and protective gowns) literally danced on the sidewalk when the dose arrived. Some people have taken pictures of themselves vaccinated, posted them on social media, and tagged them as #MyCOVIDVax.
However, the true story of the debut of COVID-19 vaccination is more systematic than the monumental one that celebrates teamwork rather than conquest. The hospital considered a carefully crafted plan while waiting for the first assignment. They depended on each other, straddled the usual sectors of competition, and worked together to share a limited supply. The first vaccination priority list included environmental service workers cleaning the room and life-saving emergency physicians working to save lives.
“Healthcare professionals have been gathering throughout this pandemic,” said Melanie Swift, MD, co-chair of the COVID-19 Vaccine Allocation and Distribution Working Group. Mayo Clinic In Rochester, Minnesota. “We experienced the darkest years of great dependence on each other,” she said. “Now we are pulling together to get out of it.”
Still, there are problems with deployments of this scale. Stanford University announced an apology on Friday after residents protested the vaccine distribution program. The plan excludes almost all residents and fellows, many of whom regularly treat patients with COVID-19.
Already there Over 287,000 COVID cases According to the US Centers for Disease Control and Prevention (CDC), the death toll of healthcare workers is 953.inside that guidance“Their continued protection at work, at home, and in the community remains a national priority,” the agency said. This means immunizing a workforce of about 21 million people, often the largest group of employees in the community.
“To maintain the stability of the healthcare infrastructure across the Atlanta Metro area, teams need to be vaccinated,” said Christy Norman, Pharm D, Vice President of Pharmacy Services. Emory Healthcare, The health system was waiting for the first delivery, so I told reporters at the briefing.
Don’t waste your dose
One of the top priorities is that hospitals don’t want to waste their doses. Pfizer vaccine storage requirements make it tricky.
When you take the vial out of the box-shaped container of pizza stored at a very low temperature and put it in the refrigerator, Must be used within 5 days.. Thawed 5 dose vials should be warmed to room temperature before dilution. Within 2 hours.. After diluting with 1.8 mL of 0.9% sodium chloride injection, the vial should be used within 6 hours.
COVID-19 precautions require employees to be physically separated while waiting for their turn to vaccinate. In other words, this process cannot reflect the general large scale. influenza Vaccination program.
To prioritize the group, Mayo vaccination planners conducted a thorough risk stratification, taking into account the duties of each employee. Do they work in a dedicated COVID-19 unit? Do they handle lab tests or collect cotton swabs? Do they work in the ICU or the emergency department?
“We apply some principles when deploying to prioritize those who are at greatest risk of continuous exposure and who are critical to maintaining COVID compliance and other important medical services. We did, “said Swift, an associate. Medical Director of Mayo Occupational Health Services.
Mayo employees eligible for the first dose can sign up for appointments through the medical record system. If you suspect that some doses are likely to remain at the end of the vaccination period (probably because you missed an appointment), a supervisor in a high-risk area can refer you to another healthcare professional. .. Mayo vaccinated her first vaccination on Friday, but the vaccination program began in earnest this week. With the pleasant surprise that each 5 vial actually provides 6 doses, the 474 vials allow vaccination of 2844 employees in the top priority group. “As the amount of vaccination increases, it will increase weekly or in days,” Swift said.
Share vials with a small country hospital
Minnesota uses a hub-and-spoke system to provide access to Pfizer vaccines to smaller rural hospitals, but without ultra-cold storage, the minimum order volume of 975 doses cannot be used. Large hospitals that act as hubs share orders. (The minimum order for Moderna is 100 times.)
For example, in South Central Minnesota, two hub hospitals each have six spoke hospitals. Five of the 14 hospitals are independent and the rest are part of a larger hospital system, but affiliation is irrelevant, said Eric Weller, Community Health Care Preparation Coordinator. South Central Healthcare Union.. “We all work together, it doesn’t matter which system you come from,” he said. “We work for the benefit of the community.”
Each hospital provides vaccination education, prioritizes groups, assigns appointments, registers people for vaccination, obtains a signed consent form, administers vaccines in a COVID-safe manner, We designed a process to provide follow-up appointments for the second vaccination. “We are using some of the lessons we have learned H1N1“Weller mentioned vaccination during vaccination.” 2009 influenza pandemic.. “The difference is that there will be a line of people during H1N1.”
Appointment adjustments are more important than ever. “One of the vaccination strategies is to bring people into groups of five, so use one vial for every five and don’t waste it,” Weller said.
Logistics is a little different from the Moderna vaccine. The Moderna vaccine is provided in 10-dose vials. Refrigerate for up to 30 days..
Both vaccines can cause mild flu-like symptoms such as malaise. headache, Or muscle pain, especially after the second dose. This indicates that the immune system is responding to the vaccine, but it is also another consideration for vaccination planning, as healthcare professionals may rest for a day or two. “We are not going to vaccinate the entire department at once. It will be staggered,” said Kevin Smith, MD, MD, Medical Director of the Occupational Medicine Program. ProMedica, A medical system based in Toledo, Ohio.
Smith said he plans to encourage employees to use it. V-SafeAn app created by the CDC to track the negative effects of people receiving vaccines. He pointed out that a day or two of pain would be better than dealing with the symptoms of COVID-19. Some employees who have recovered from the infection are still tired and have not regained their sense of taste or smell. “We’re still monitoring a significant number of employees to make sure they’re back at 100%,” he said.
Hoping to end the pandemic
Public health officials have been worried about vaccine hesitation, even among healthcare professionals, but so far that concern seems to be overshadowed by enthusiasm. According to Smith, his department responds to calls from employees who want to know when they can get the vaccine. “I think everyone is relieved,” he said. “We are at the beginning of the end.”
In Mayo, Swift is investigating staff to measure their willingness to vaccinate, but she’s already excited about her employees. “There is no doubt that some people are still hesitant, but I’m feeling the change,” she said. “I feel that healthcare professionals are getting more involved and wanting to get this vaccine. This is good because it sets an example for patients.”
The past month has been touching for Dr. Colleen Kelly, MD, an infectious disease specialist at Emory University in Atlanta and a senior researcher at Emory University’s Moderna clinical trial site. “For a while things looked very dark and dark, but then things began to give results of these effectiveness better than anyone could have imagined,” she said.
Kelly spends time talking to journalists and educating fellow doctors and hospital employees about how vaccines are developed quickly and how they work. “Everyone asks me,’Should I get it? Are you going to get it?’ My answer is’yes’and’yes’,” she says. It was. “I am 1000% convinced that the benefits of widespread vaccination outweigh the risks of ongoing COVID and ongoing pandemics.”
Michele Cohen Marill is a freelance journalist based in Atlanta. She has contributed to Wired, STAT, Health Affairs, and other publications.She can reach at [email protected]..
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