Fragile COVID-19 Vaccine Providers Must Follow Stringent Dose Handling Guidelines

February 22, 2021 at 10:16 AM PST

Speaker 1: 00:00 Speaker 2: 00:38 Speaker 1: 01:58 Speaker 2: 02:01 Speaker 1: 02:31 Speaker 2: 02:35 Speaker 1: 03:12 Speaker 2: 03:17 Speaker 1: 04:08 Speaker 2: 04:15 Speaker 1: 05:01 Speaker 2: 05:08 Speaker 1: 05:44 Speaker 2: 05:54 Speaker 1: 06:16 Speaker 2: 06:25 Speaker 1: 07:23 Speaker 2: 07:27 Speaker 3: 07:44 Speaker 2: 07:47 Speaker 3: 07:54 Speaker 2: 07:58 Speaker 3: 08:01 Speaker 2: 08:11 Speaker 3: 08:33 Speaker 2: 08:37 Speaker 3: 08:56 Speaker 2: 09:07 Speaker 3: 09:16 Speaker 2: 09:27 Speaker 3: 09:41 Speaker 4: 09:53 Speaker 2: 09:56 Speaker 4: 10:10 Speaker 2: 10:28 Speaker 3: 10:35 Speaker 2: 10:52 Speaker 4: 11:21 The Petco park vaccine service station remains closed today due to delays in vaccine shipments. Other walk-in vaccination sites remain open in San Diego. Meanwhile, the number of new COVID cases in San Diego continues on a downward trend. So hopes are high that the winter surge may be slowing, but experts warn that this is not the time to let our guards down. Joining me with a COVID update is KPBS health reporter, Taran, mento, and Taran. Welcome. Thanks, Maureen. How do the numbers of new cases and hospitalizations compare with what we were seeing just a few weeks ago? Well, the numbers are better, but still pretty high daily new reported cases have been below a thousand for about 10 days. That's that's good. A few weeks ago. Uh, the County was confirming 3000, 4,000, even older, over 5,000 new cases some days. So a huge drop, but to put this in perspective a bit back when we were, you know, closely watching our case rate, which determines what stage of reopening we're in County officials said new cases should be within the 250 a day range and a case rate of seven per 100,000 or less would get us into a little bit less restrictive level of reopening. Last time I checked our case rate was around 22 per 100,000. Now that has come down a lot recently. And Dr. Wilma Wooten, our County public health officer said we could be reaching that case rate, um, which is at, or below seven in the next couple of weeks. If this decline in new cases continues, hospitalizations are also looking better. The rates are dropping, but not as drastically as new reported cases in that may be because we know there's about a two to three week lag between increases in cases and later increases in hospitalizations. So officials mentioned that that may be the same case with decreasing hospitalization. So hopefully those, those lower rates will continue to go that way. Are deaths also declining? It's kind of up and down, still a little erratic. Some of that may have to do with the reporting process hospitalizations, as I said, lag behind new cases, but by about two to three weeks. So the number of reported deaths will lag even further. So the impact of the reduced number of new positive cases may take a little while longer to show up in the number of lives lost. But County officials have said that they hope the emphasis on vaccinating, the older vulnerable population right now will also help reduce that tally. Why do experts think the rates of infection are down? Well, they've been talking a lot about the post holiday surge. We know when we see jumps in cases followed by increases in hospitalizations about two weeks later. And then unfortunately that could lead to an increase in deaths. So officials attributed that jump in cases to gatherings that occurred maybe as really as Halloween. So we've moved past that period, hopefully, but they were also concerned about seeing a post Superbowl bumps. So anytime there's an opportunity where people may be able to gather that's where that concerns comes from of increasing the numbers. But hopefully after the surge, people may have recommitted to those measures, um, to, to slow the spread. How about the variants? Have they taken hold as much as researchers feared? It seems we're still waiting to see that there was concerned that the new variants could create an even greater surge than when we saw over the holidays, which left us with very limited hospital capacity at times and union tribunes a reporter. Paul Sisson just looked at this projections show that we could be seeing thousands of cases a day around this point. But as I mentioned, we're seeing less than a thousand fluctuating around 500, 800. So his report tried to answer why that was, and it could be the vaccinations, even though supply has been challenging to say the least it could be a natural seasonal change in the virus. It could be better behaviors among the public following that, that surge. Um, it, unfortunately it seems like a wait and see scenario. So officials are urging people not to let down their guard stay masking, stay distance. Okay. Despite the good news of the downward trend in new cases, what are health officials concerned about? So again, it's going to be that scenario is how are these variants going to play out? Are we going to see that surge? We're still looking at how the virus does hold up, uh, or excuse me, how the vaccine does hold up against some of these variants. Some of the news has been positive, but it's really, um, limited data at this point. So we're going to have to kind of see how that goes. And also they're just kind of worried that as we are seeing declining numbers, maybe people will start to be a little bit more comfortable with not adhering to all of those rules. Maybe they get a vaccination, um, either their first dose or even their second dose. And they're not kind of following all of the guidelines because they do want people to continue practicing those measures, to make sure that they're not spreading it to anybody, even though they may be protected from any severe illness with the vaccine, The vaccine shortages that they are experiencing at Petco and other sites, are they all due to bad weather back East? That's what we've been hearing. Um, the County during its news conference last week did say that that's the reason why we're hearing about, um, vaccinations, uh, appointments being canceled. The manufacturers of the two emergency approved vaccines right now are located, I believe in Massachusetts, in Michigan, um, where they have a completely different winter than we do. And so if you thinking about transporting something, um, you know, and have you, winter roads are bad and things become more complicated. So that can, that has led to, um, you know, difficulties in getting vaccinations to where they need to be. When are the sites and I'm referring to Petco and the other that had vaccine shortages, what are they expected to be up and running again? And how are they handling people whose appointments have been missed? So last week during the counties news briefing Fletcher did say that we could be seeing an impact from these, um, supply issues or these transportation issues. Um, for, you know, maybe a week to 10 days, they're encouraging people to make sure that they're checking their email and checking their appointments. And if they did have one and it did get canceled, they will, um, be rescheduled. Now, although these big super sites like Petco get a lot of attention, Taron, you visited the vaccine preparation at a local community clinic. Tell us about that. Right? Family health centers of San Diego has been doing some vaccinations among their patients and the public for a little while now, but they are hopeful to launch a larger site. They want to vaccinate up to a 750 people a day at their first larger vaccination site that they hope to open in the Logan Heights area, which actually has some of the highest rates of COVID-19. But some of the lowest numbers it's in an area that has some of the lowest numbers of vaccination. So they're working on getting that up and running, but we've been documenting all of the many challenges. Obviously vaccine supply is a big one. Um, but also just the little things they need to pay attention to. I mean, you have to have the vaccine either whether it's Madrona or Pfizer kept it very cold. Temperatures Pfizer, more so than Medina. We previously documented the all logistics of setting something up. And now this feature gets into all of the many different things required with properly handling the vaccine to make sure that it remains viable. Thanks, Taran. And here's that report A gentle swirl of the COVID-19 vaccine. Vial is critical. Anything more could render the dose in effective before it fills a syringe and penetrates an arm. The risk begins even before the Shipt vials cross the threshold at family health centers of San Diego, They're packed very carefully to minimize disturbance. Lisa Duncan is vice president of nursing and clinical compliance at family health centers. She oversees vaccinations at the community clinic They're frozen, so that helps they don't get sloshed around. Can't even be relocated offsite without a prior. Okay. They can maybe have one transport that has to be approved in advance to transfer vaccine supplies so that the everyone knows where the vaccines are. The vaccines fragility adds an extra layer of complexity for providers. They must inject doses quickly to reach the county's vaccination goal by July, but they also must take great care. Mishandling can destroy the vaccine's potency and ongoing supply challenges mean backup doses are practically. Non-existent A great art and science of managing that vest. This vaccine Family health centers, current small-scale operation in their break room is sort of a trial run. They're planning to vaccinate hundreds of people a day at an upcoming site outside their Logan Heights clinic. But the nation's limited vaccine supplies have delayed its opening, making proper handling that much more critical. So is a conference Room that we've repurposed for staging the vaccine. We have a freezer here that when the vaccine arrives from the manufacturer, we put it right into the freezer, The pharmaceutical grade freezer, that's no bigger than a college dorm. Fridge is the key component. Anything outside the required cold temperatures, triggers and alarms, It's hooked up to our wifi and it'll send us a message whenever. Or if we have, hopefully it doesn't happen. But if the unit goes out of range, then we're notified immediately. But the vaccine must actually be thawed before it can be used. It'll last up to 30 days in a fridge, but only hours in the room, down the hall where dosing takes place. And once the vial is pierced, it has a six hour shelf life Constantly looking at how much needs to go in the refrigerator. Um, how much do we pull out and put into the room? How long has it been in the room? Um, how long has it been open since you took out the first dose Almost as though you were dealing with a chocolate? Dr. Dale Hewlett is deputy health commissioner for Westchester County in New York. He credits another scientist with the analogy, but recounts it to explain the vulnerability of a key ingredient in the vaccine, ribonucleic acid or RNA. And if you have chocolates, you know that if you get to a certain temperature, it's going to melt. Hence the cold, you have insights that will destroy the integrity that are not going to be active when you have a very low temperature. But when you have a higher temperature, those enzymes will become activated. There's like family health centers have coordinators whose sole job is to monitor the safe handling and storage of vaccines. All of us are very much aware of the parameters and back each other up on that. But generally one person is in charge of making sure that the supply is moving out of the refrigerator appropriately. And then at the end of the day, um, everybody starts sharing the vile so that we don't open it. Every detail here will be duplicated and expanded at Logan Heights. Family health centers is hoping it will accommodate up to 750 people a day, but vaccine supply shortages mean it's on hold for now. They're hoping shipments will flow early next month. Thanks to an upcoming federal program that prioritizes community clinics, Taryn mento, K PBS news. [inaudible].

By KPBS Public Media

A degree too warm, or a room too bright, could render a vial ineffective at a time when shipment delays and shortages mean back-up doses are practically nonexistent.