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Doses of Pfizer’s coronavirus vaccine, the first expected to gain federal approval, could arrive in Massachusetts in mid to late December. Hospitals should expect 975 doses in each cooler, identify their first 975 frontline staff who will receive it and then the next 975. Hospitals that don’t have super cold (-80 degrees Celsius) freezers should get in touch with their local dry ice supplier ASAP.
That’s some of the latest guidance from the state Department of Public Health as Massachusetts and communities around the world prepare for an historic coronavirus vaccination campaign. The DPH instructions apply to phase one, which is expected to include vaccines produced by both Pfizer and Cambridge-based Moderna, although Moderna has not yet filed for federal approval.
Hospital leaders say federal officials have suggested a wide range of estimated doses that may come to Massachusetts, between 200,000 and 700,000, depending on when the Moderna vaccine is approved.
The first doses may be limited to hospitals and long-term care facilities. The state’s interim plan says other essential workers might be included in the initial offering of vaccines, but there’s no mention of the other workers in this update. Some community health workers, teachers and EMTs say they should be on the list for early vaccines as well.
The CDC, in partnership with CVS and Walgreens, is managing vaccination of staff and patients at long-term care facilities. The DPH guidance for hospitals says priority should be given to health care personnel in direct or indirect contact with COVID-19 patients or infected materials. That includes doctors, nurses, radiology technicians, the people who disinfect rooms and cafeteria staff.
Even on the current high end of vaccine projections — 700,000 — there would not be enough doses for all those hospital employees, estimated to number about 350,000, and the thousands of employees and residents of nursing homes and other long-term care facilities. Both the Pfizer and Moderna vaccines are delivered as two shots administered several weeks apart. So 700,000 doses would cover 350,000 people. Hospitals say coronavirus vaccination will not be required for staff, at least not until there is enough for all health care workers.
Both the Pfizer and Moderna vaccines will come with the needles, face shields and other items used to give the shots. The Pfizer vaccine can either be stored in specialized freezers or kept in the coolers it arrives in, as long as the container is not opened more than twice a day for no more than three minutes each time and is repacked with dry ice every five days.
There’s concern that some Pfizer vaccines may be thrown out if they aren’t used quickly enough or if the hospitals don’t use all 975 doses. That’s less of a concern with Moderna’s vaccine, which DPH says will be shipped in 100-dose packages, can be stored in standard hospital freezers and does not need to be reconstituted with a liquid before administering.
To receive shipments of the vaccines, hospitals must be enrolled in the Massachusetts COVID Vaccine Program. They must be ready to submit information about who gets dose one and two of which vaccine to the state’s electronic registry. Hospitals also need a process for making sure staff return for their second dose in keeping with a strict timetable — 21 days later for Pfizer, 28 days for Moderna
If those record-keeping challenges aren’t enough, here’s another: staggering delivery of the vaccine within each unit or department. Hospital leaders don’t know how many employees will experience side effects such as a fever or fatigue as happens sometimes after a flu vaccine. Hospitals and long-term care facilities say they will need a vaccination schedule that doesn’t leave them short staffed during a surge of COVID cases and the holidays.
Federal health officials plan to monitor everyone who receives a coronavirus vaccine, using the new V-Safe texting app. And anyone who experiences something more than mild symptoms is urged to report them.
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