Lately, Jon Horton has been dreaming about freezers.
"I was opening the freezer and I was taking something out of the freezer and putting it in something else," Horton said. "And it was just like — whew!"
And not just an ordinary freezer. Horton is pharmacy operations director at Sentara — a health care network based in Norfolk, Va.
Sentara officials are working out every detail of the logistics involved in rolling out the coronavirus vaccine from Pfizer, which has to be kept at nearly minus 100 degrees Fahrenheit or risk losing effectiveness.
"At a certain point, you're just trying to figure out what needs to be done next," Horton said during an interview with NPR at Sentara Norfolk General Hospital. "So you're focusing on this process, and as you open up that door, you learn a little more."
As federal regulators prepare to meet Thursday to consider whether they'll approve Pfizer's brand-new coronavirus vaccine, employees like Horton are preparing to receive the vaccine at hospitals around the United States.
The Sentara health system has four of the ultracold freezers that the vaccine requires, including one obtained through collaboration with a local medical school.
"We usually just deal with freezing temperatures, you know, a typical freezer," said Tim Jennings, Sentara's chief pharmacy officer. "That's why we had to actually go out and acquire a special freezer for this."
For sites that don't, there's dry ice. Jennings opens a big blue bin full of it, which resembles white "cheese doodles," he notes.
There's little room for error here: The vaccines must be monitored to make sure the temperature is stable each step of the way. And they're in short supply right now; the first shipment from Pfizer is expected to include only about 72,000 doses for all of Virginia, a state of more than 8 million people.
Michelle Hood, chief operating officer at the American Hospital Association, said health care administrators across the country are gearing up for a major logistical undertaking.
"We've never done anything like this as a country or in the world, as significant as this exercise is," Hood said. "And everything is new."
The first vaccines will go mostly to front-line health care workers at the highest risk of exposure.
That's where Mary Morin, a vice president in charge of employee vaccination at Sentara, comes in. She has a lot to think about as well.
"I did wake up last night and I'm going, 'Oh, my God,' " Morin said.
Morin, whose background is as a registered nurse, has to turn Centers for Disease Control and Prevention guidelines about who should be first in line for the coronavirus vaccine into a real-life plan for her hospital workers.
"A front door to the hospital is the emergency department. You may have a security guard there. They're patient facing. They're forward facing," she said. "So it's the staff — it isn't just the nurses and the physicians."
Unlike the flu shot, Sentara officials say, the coronavirus vaccine will be optional for staff. Large studies indicate the Pfizer vaccine is about 95% effective with few side effects. But it's brand-new, and convincing people to take it may be a challenge.
The challenge ahead for hospital staff members like Jennings is making sure the vaccine is properly stored and administered to those who are willing and able to take the first doses. If the vaccine receives federal approval, officials say it could start being given to health care workers within days.
"We realize if we do this right, we could save thousands of lives," Jennings said, "if not hundreds of thousands."
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