Our Week as COVID Vaccinators: Feb 1 thru Feb 6

There are weeks, and then there are WEEKS.

Vaccine Supply Adventures

We started the week feverishly adjusting schedules. Allocations were slashed, so we pushed appointments back.

Then on Monday a surprise. Just like drawing a certain card in Monopoly:

How we proceeded with the extra doses

After discussion with multiple WA Department of Health employees, we adopted the go forward plan. They allowed us to keep the vaccine. But, we had to get it in arms quickly. If not, we might not get additional shipments. Or, it might get diverted elsewhere — like we saw in January when supplies moved to Skagit.

This is from a recent DOH email this week:

Advice conveyed included permitting unadvertised walk-ins.

We moved forward.

You see, this is a government-owned vaccine. While we could have proceeded with just our appointments only, that would’ve been risky. That is if our goal is to vaccinate as many people as possible going forward — and it is.

Second Dose Orders

From the beginning, second doses were supposed to be allocated automatically. However, the state has experienced some challenges. They are actively updating internal procedures to correct. However, our second doses for the week of Feb 8 appear to be in peril — temporarily we expect.

Inexplicably, our 700 dose order for this week was rejected. Even though Sunday (Jan 31) we took steps to communicate with state staff way ahead of fulfillment. Unfortunately, they had an internal communication interruption of some kind.

We have been in contact with state and county officials thru this weekend even to ensure they rectify the situation. The correction may not occur in time for doses to be administered this week. Detailed documentation of first doses administered for the corresponding time period is in the hand of state officials. We anticipate getting the weeks of Feb 8 and Feb 15 booster doses together — hopefully.

Here is another communication from the state:

So, we will not be canceling second dose appointments, but they will be moved around to match vaccine arrival dates when confirmed.

What if I get my second dose late?

Good question.

First, don’t worry! It may actually end up being more beneficial, at least according to an epidemiologist who advocates delaying second doses:

“Minnesota epidemiologist Michael Osterholm said Wednesday that he will ask federal health officials to re-examine COVID-19 vaccine data with an eye toward delaying the second dose so more people can quickly receive first shots.

Osterholm, speaking before a Minnesota House health committee, said immunity protection improves with many other vaccines when doses are spaced out by months.”1

Another article conveys a similar message :‘WHO: Amid short supplies, vaccine doses can be 6 weeks apart’2

We have talked with Skagit and Island County Health officer Dr. Howard Leibrand. He also communicated that delaying the second dose a bit is of no concern.

So, while we work to ensure the state sends us your second doses, please be assured your COVID-19 immunity status is not in jeopardy.

Officials with UW Medicine said some patients will wait six weeks between doses.

“Your vaccine will still be safe and effective within this full timeframe,” UW Medicine said on its website.

Dr. Deborah Fuller, a professor in the Department of Microbiology at the UW School of Medicine, has studied vaccine dosing timeframes and said the longer window shouldn’t stress patients out.

“The immune cells that are primed by the first dose are going to be there, they’re going to be ready to respond whether you get your [second dose] at three, four, five, or six weeks, it’s still going to work just as well,” she said.

Overlake Medical Center and Hospital said it’s scheduling second doses within the three to six-week CDC-recommended timeframe.

The CDC said it’s not advocating for a delay in dosing, but data from clinical trials back up their guidance about the six weeks option.

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Your Every Day Mass Clinic Vaccination Destination

We hear a lot about ‘mass clinics’ for Covid Vaccination across the country. Unfortunately, it seems that as politicians stand up mass clinics in big cites, supplies available locally wane.

Our staff demonstrated this week we can stand up our own mass clinic.

2900 doses administered as a company this week

Clinton ran about 100 per day this week in scheduled 10 shot per hour appointments.

La Conner had plans to vaccinate, but their 200 approved doses never shipped (still don’t know why, awaiting reply from the state).

Now, about Oak Harbor.

Our order came in about 10a Monday. We started vaccinating at noon. Five hundred people received their vaccines in half a day’s work. Not bad.

Tuesday, we had some double-booked appointments by design. Staff performed efficiently and we vaccinated 750. Wednesday, we didn’t have double bookings in the morning, but did in the afternoon. Ended at approximately 650.

Thursday, we started with 990 doses in the fridge, with eyes toward getting them done. Double bookings on the calendar all day, including many advanced forward from Friday’s schedule. And, as described above, we began accepting people without appointments as well. In order to get thru this number of doses, we had to keep people moving. News spread and by the afternoon, people were flocking.

We got thru 870 doses and had to end vaccinating. The remaining doses were held for second dose appointments.

870.

Another fun fact, Wednesday and Thursday, we only had two pharmacists to vaccinate vs three Monday and Tuesday.

Quite simply, our staff was fantastic.

Further, the customers were amazing.

To get through this number, it took a cooperative effort. People who had appointments came at the right time, and used the text message arrival process. Once in the store, everyone (staff and customers) worked together seamlessly to keep moving.

This was an example of a community coming together and advancing public health.

What we learned

Our team worked hard to revamp the customer flow inside. Two distinct queues at opposite ends of the store allowed paperwork to happen separately from the vaccine line. Six-foot spacing markers were placed throughout the lines. It worked. So, the first thing we learned was how to optimize efficiency in our space.

Secondly, we now know our throughput capacity. What this means going forward is we can increase the number of appointments per hour. Our throughput was approaching 100 per hour at times. When we get allocations, we will condense appointments and maximize throughput. So, despite us having to push people back a number of weeks, we will be able to condense moving forward. We can drive 3 weeks worth of the default appointment spacing into one week if sufficient supplies arrive.

Policy Maker Engagement

Last week we encourage you to reach out and dialog with elected officials — many did. The Governor instructs DOH personnel on vaccine allocations. His office is the area of critical focus. Please continue reaching out.

Contact the governors office.

Contact any elected leader that represents you — state, county (Island | Skagit), and federal.

One engagement our team has made is Congressman Rick Larsen’s office. His team has contacted the Governor’s office on our behalf multiple times. Our discussions and performance contributed to the content in this letter submitted to the President’s office even!

Our team was one who stepped up to help an assisted living facility in Oak Harbor get vaccinated.

Please continue engaging our elected officials to help deliver vaccines locally so our citizens don’t have to venture to mass clinics far away.

Our Team

Understand our team is on the side of vaccinating as many people as possible. Natalia was even featured in a KOMO news hit last week after a producer saw her personal Facebook post expressing this same sentiment.

With that said, we understand the emotional highs and lows that go along with this pandemic. Especially true with the vaccine — a perceived path to normality.

But, please bear with our staff as we continually adjust to the changing dynamics. We respectfully request you treat them with respect during encounters — even those that end without a sore arm.

Our whole team is working to be a big part of the vaccine solution regionally. We look forward to bringing everyone through for a shot successfully.

  1. https://m.startribune.com/osterholm-recommends-delaying-second-covid-19-dose-to-get-more-vaccinated/600018583/?clmob=y&c=n
  2. https://apnews.com/article/immunizations-coronavirus-pandemic-united-nations-bb16e94b0726ca810835b7a78b1f86f6

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