Stories: Voices from the frontline
Donna Jensen, MHA, MN, RNC
The wait is finally—almost—over. With two vaccines for COVID-19 currently in the process of being evaluated by the U.S. Food and Drug Administration and a third on the way, the final stage of the pandemic may be within sight. And Swedish has been chosen as one of the first hospitals in the state to distribute the vaccines, as early as the middle of December. We spoke to Donna Jensen, the chief nursing officer of Swedish Medical Group and the head of our COVID-19 vaccine planning team, for the very latest on who will get the vaccine first, how it will be distributed and what the biggest challenges will be.
What kind of criteria did we have to meet to be a vaccine administrator?
The CDC has pretty strict requirements for what it takes to administer a vaccine to the public, and the Washington Department of Health has its own guidelines. Some of those guidelines have to do with ensuring that those who are going to be administering the vaccine can store it safely and securely.
The Pfizer vaccine needs to be stored at -70 degrees Celsius, and as soon as you take it out of that environment, it has a very short shelf life. So a lot of the planning had to do with finding healthcare organizations that could handle that. We happen to be one of them. Swedish First Hill has freezers with ultra-cold storage.
Another factor is your ability to distribute the vaccine—at least initially—to as many frontline caregivers as possible. If you don't take care of them first, you won't have anyone to take care of the people who are getting sick. With Swedish being a large healthcare system, we can vaccinate a large number of caregivers in our state with that first wave of vaccine very easily.
You mentioned caregivers are the highest priority. Who’s next?
The CDC has identified three phases. Phase one is a very limited supply of vaccine, phase two is a moderate amount and phase three is enough to vaccinate everyone who wants it. Patient-facing caregivers and high-risk patients will be part of phase one.
What makes a patient high risk is still being defined, though. We know that people over 65 experience COVID much more severely, so would they be high-risk? Probably. We also know that people with comorbidities like COPD or congestive heart failure or diabetes also have a harder time with COVID. So they would likely be in that high-risk category as well.
How soon might there be enough vaccine to move into phase two?
If we only had one vaccine, the original estimate from the CDC was that we would be in a position to move to phase two within 15 to 20 months. However, now that it looks like we’ll have a second, from Moderna, and possibly even a third at the beginning of next year, that could shorten the timeframe significantly.
Which one of those vaccines will we get at Swedish?
We’re not sure just yet, but I would suspect that we will end up with more than one brand. That will add a little bit of complexity, because they all have different storage requirements and different shelf lives. Each one requires two doses, and the time between the first and second doses is different for each. Pfizer is a minimum of 21 days apart, Moderna is 28 days and AstraZeneca is 30 days. So it will be our responsibility to track which one you got for the first dose and ensure you get the same one for the second.
What will be the most difficult part of the process?
We’ve figured out the storage, which everyone thought would be difficult. And we know how to set up a vaccine clinic under the current conditions, because we’ve refined it over the last two months as we’ve administered the flu vaccine to the community. So we know we can pull off the logistics of vaccinating a large number of people.
At this point, the current challenge is helping the public understand the risks and benefits of taking the vaccine. We have more questions than what we can answer right now, so between now and the middle of December, when we think we're going to have the vaccine for caregivers and high-risk patients, we’ll need to work on helping people not think that they have COVID because they got the vaccine and don’t feel well. It’s simply not feasible to get the virus from the vaccine. But does it make your body think it has the virus and then create antibodies needed to fight it off? Yes. We all experience that differently and have symptoms that go along with it.
How will someone who gets the vaccine be able to prove to, say, an airline or an employer that they’ve been vaccinated?
The vaccine is coming with cards from the CDC similar to what we got when I was a child—a card with the date and the name of the vaccine. You’ll get that with your first dose, and then hopefully you’ll bring it back when you get your second dose. But if not, we’ll be able to give you another one.
We will also be required to give the state daily updates on who has received the vaccine. That information will be shared with the CDC, and you, as the person who received the vaccine, will be able to log on to the CDC’s website and report any symptoms that you experienced. We actually report all vaccines to the state. This is a little more rigorous in that it gets uploaded daily to the CDC as well.
In your career, what else have you done that begins to resemble this?
I've been around for H1N1. I've been around for HIV, which was pretty scary at the time for lots of people and changed a lot of our healthcare practices. I have even been around for Ebola. This is unprecedented.
In each case, though, we have risen to the challenge, through science. We’ve learned what it is, how it’s transmitted, what we need to do to protect ourselves as well as others, and then we’ve gone forward and taken care of what we need to take care of.
Swedish will reach out to high-risk patients to let them know they are eligible for the COVID-19 vaccine and schedule an appointment.
Even as we prepare to protect the public moving forward, we’re still caring for those who have already had COVID-19. For information on how you can support treatment for patients experiencing persistent, debilitating symptoms at our COVID-19 Recovery Clinic, please contact us at 206-386-2738 or [email protected].