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The logistics of the COVID-19 vaccine and administration

Tuesday, December 15, 2020

It's on the way: The logistics of the arrival of the COVID-19 vaccine and administration

The Food and Drug Administration (FDA) has approved the Pfizer COVID vaccine for emergency use. The Centers for Disease Control and Prevention (CDC) has authorized the vaccine for those age 16 and older. On Sunday, Pfizer began shipping the vaccine to 600 sites across all 50 states. Augusta Health is one of those sites, and its vaccine is expected to arrive on Tuesday, December 15.

The vaccine, which must be stored at extreme temperatures and required the purchase of a special ultra-low subzero freezer for storage, has been shipped in containers designed by the manufacturer to maintain the correct temperature ranges during transport. When it arrives at Augusta Health, it will immediately be taken to the storage area to be unpacked and placed directly in the ultra-low freezer according to the manufacturer's receiving process. The freezers have a continuous temperature monitoring function to ensure storage temperature is maintained. A perpetual inventory system is used so pharmacists always know how much vaccine is in house and the exact location of the vaccine.

In accordance with the Virginia Prioritization Schedule developed by the Virginia Department of Health (VDH), the first to be vaccinated with this shipment of vaccine are healthcare personnel in hospitals and health systems who 'directly engage in the care of or interact with patients known or suspected to be infected with COVID-19'. Augusta Health employees and providers in this group received a communication last Friday to inform them of their 'Tier 1' status. Working with supervisors to ensure patient care is not interrupted and to assist pharmacists in coordinating the administration of the vaccine, appointments are being scheduled for injection. If the vaccine arrives as scheduled, the first round of vaccinations should begin on Wednesday and be completed within a week, with second doses to be administered three weeks after the first.

"Once we have a firm count of how much vaccine we need and when exactly we need it, that amount will be thawed according to the instructions in the Emergency Use Authorization," says John Mack, PA, Chief Operations Officer of Augusta Medical Group and member of Augusta Health's Vaccine Task Force. "Once the vial of vaccine leaves the subzero freezer, it is good for five days. This allows us to transport it, under refrigeration and with a temperature monitor, to the administration site that is located near the storage site. Each vial contains five doses of vaccine, and once the dose is mixed, it's good for six hours. We will be mixing the vaccine immediately before its needed, and drawing it as the recipient is seated and ready. We want to be good stewards of every drop of vaccine we receive."

Augusta Health has agreed to receive and store the vaccine for other hospitals and health systems in the region that do not have ultra-low subzero freezers. Approved plans for this distribution were filed with both the CDC and the VDH. A high level of coordination will be required so the receiving hospitals can retrieve, transport under refrigeration, and administer their vaccine within the five-day limit after leaving the sub-zero freezer at Augusta Health.

"Collaboration and coordination have bywords for the whole vaccine administration process," adds Mack. "From the very first planning meetings to the detailed arrangements for receiving, storing, and administration, it's been an amazing and sincere group effort among the VDH, the Virginia Hospital and Healthcare Association, and all hospitals and health systems throughout Virginia. It's been gratifying to be part of a process so focused and so cooperative. Everyone has put the health and safety of our communities at the forefront of what we need to accomplish, and accomplish well."

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