The CHA Everett hospital has received its first doses of the Pfizer-BioNTech COVID19 vaccine this week and could begin vaccinating prioritized workers at the facility this week or early next week.
Dr. Melisa Lai-Becker, chief of the Emergency Department at CHA Everett, said the facility applied for and received 975 doses of the vaccine, which is the smallest amount one can receive from the federal government’s Operation Warp Speed vaccine project. She said having the vaccine on hand is an amazing thing, but she cautioned that it’s going to be a long slow process with several limiting factors to deal with along the way.
“It looks like we are very fortunate that we’ll be receiving a shipment of 975 doses,” she said Monday night. “The goal is if you order that first 975, you need two injections spread two or three weeks apart, then you’ll get a second set of 975 doses…We might be able to start vaccinating by the end of the week, but we’re being very methodical so we can make sure things are organized. There is no rush. The vaccine is arriving to us in these deep freeze systems in vaccine grade glass that can withstand all kinds of transportation. Once it’s here, apparently there is a window of 35 days to keep it in its original container and use it.”
The hospital has been tasked with figuring out who is the first to get the vaccine in their Group 1A round of vaccinations. She said at CHA Everett, they have made the highest priority those who are geographically closest to those with COVID-19.
“The first will be those who are most likely to come into contact with patients who have COVID-19,” she said. “It will be based on geography in the hospital instead of just your role. For example, if you’re a radiologist reading in a reading room and not coming into contact with patients, that’s different from a radiology tech that goes into the room of the patient with COVID-19 and snaps the X-ray…We really want to make sure our housekeeping and back of house service providers in the Emergency Department and ICU are highly prioritized – the food service team as well.”
The process at the hospital with the first group and others will include a slow trickle of vaccinations, she said. Dr. Lai-Becker said there has been a remarkable and reassuring amount of information coming from the federal and state government, and from manufacturers as well. That information has included the fact that about one-third of those in the clinical trials for the vaccine felt slightly sick for about a day or two after the second shot. That means, she said, they need to take precautions and be ready for people to be out of work following vaccination. Being that there are a lot of patients seeking care now for COVID-19 at the hospital, they can’t very well lose huge swaths of the staff to a vaccination reaction.
“We certainly wouldn’t want 70 percent of the staff getting vaccinated on the same day because we don’t want to run the risk of tons of people being out,” she said.
At the same time, she said it will be important for people to be patient and wait for the right time. She said it is probably overly optimistic to think that low-risk people will have the vaccine available by May, but she said it is incredible to think that 10 million doses (or 5 million people) will be vaccinated by the end of the year – only about one year from when the virus was truly recognized.
“I feel very good about it and I’m also trying to be as realistic about it as possible,” she said. “It’s incredible to think the first folks here in Boston are about to get the first vaccine in days if not hours. One other thing to temper and keep in mind is it’s not an actual 300 million doses that falls into our laps…I’m fixated on and reminded there are 330 million people in the United States and each person requires two doses…It is incredible there will be 10 million doses produced by the end of the year just for Pfizer and Moderna. But that really means that 5 million out of 330 million will be vaccinated.”
As a further example, she said CHA Everett has 975 doses now, and presumably 975 doses coming for the second booster. However, there are more than 1,000 people working in the high-priority COVID-19 areas. That example is one that she said is important for people to remember as the vaccine rolls out. It won’t be a flood of healing, potentially, but a slow trickle over many months.
“The vaccine coming does not mean that the firehose is hooked up to the fire hydrant, and we are putting out a fire in someone’s backyard,” she said. “We’re not dousing someone’s fire pit with a firehose. This is a coordinated series of bucket brigades going on throughout everyone’s neighborhood.”
•Glass Could Be a Slowdown
Dr. Lai-Becker said she and others in the Emergency Department have never known so much about the simple supplies they use until COVID-19 hit. They learned about what goes into making masks, ventilators, and how complicated the process is and the supply chain for making them is.
Now, they are getting those same lessons with the vaccine, and it could be glass – of all things – that slows down the complete rollout of the program. Apparently, the glass used for all vaccine vials is a very special glass that is required for everything from the flu shot to an MMR booster. It has a special manufacturing process and it’s not likely that it will be able to keep up with the demand for vaccine. That could become a limiting factor in the process. Already, they have packaged five doses for every vial in the Pfizer vaccine to limit the amount of glass being used.
“As it turns out, they won’t be able to have single-dose vials because it would be difficult to produce that much glass,” she said. “The glass used for this vaccine and all vaccines is a special grade of glass needed for vaccine storage, whether a flu shot or a rabies shot. I guess the production of this glass is one limiting factor in producing vaccine.”
•Skepticism Is Natural, but Not Necessary
If one talks to any number of folks around the area, there are some strong opinions on either side of the coin about whether or not they will get the vaccine for COVID-19. After all, it employs a brand new process using messenger RNA (mRNA) rather than using an actual part of the virus to build up immunity. Some have no fear of that, and some do.
Lai-Becker said the process doesn’t change one’s DNA, as has been postulated by many, and she said there has been so much written about it and the process has been extremely transparent. Also, tens of thousands of people have volunteered already to get it in clinical trials, and they have been studied carefully.
“Pfizer uses mRNA and I totally understand people hearing RNA and thinking – is that DNA?” she said. “They wonder if you’re going to be messing with their DNA. I can understand people think about this. I watch movies. Who hasn’t at least heard of Frankenstein? I’ve had a chance to review all the information myself and participated in Webinars on it. As someone who works in healthcare, looking at the data and how the vaccine works, it both makes sense and looks to me like it’s a really important advance and breakthrough that is as big if not bigger than the first vaccines for smallpox.”
She explained that the mRNA is put into one’s body and gives instructions for the body to produce one of the “spikes” that is seen on the COVID-19 “crown.” Then the mRNA dissolves like any other mRNA in the body. That spike circulates around and causes the body to take note and eradicate it – teaching the body to eradicate anything else like it, including the actual COVID-19 virus.
“It’s so beautiful actually because it’s so straightforward and goes so classically with smallpox and what Jonas Salk did with Polio…It tells the body to fight without actually having to fight the virus.”