For respiratory therapist Kathleen Bonis, RRT-NPS, this was the moment she’d been waiting for. She was the first ChristianaCare caregiver to receive the COVID-19 vaccine.
Bonis is clinical manager for Respiratory Therapy, a frontline team that cares for patients in the hospital who have breathing problems — including patients with COVID-19.
“Getting the vaccine is one of the ways I can really help protect myself, my family, my community and my colleagues. I wanted to get it not only for myself but for all the people around me,” Bonis said.
According to plans developed by the federal and state governments, the initial supply of the vaccine is designated for health care workers, first responders and vulnerable populations such as people in long-term care facilities.
Caregiver vaccinations with the Pfizer-BioNTech vaccine at ChristianaCare started on Friday, December 18, at the Newark and Wilmington campuses in Delaware. Vaccinations at ChristianaCare’s Cecil County campus started on Monday, December 21, when the first shipment from Maryland of the Moderna vaccine arrived. By Monday evening, more than 1,700 caregivers had already been vaccinated across the three hospital campuses. Vaccinations were planned to continue until every caregiver who wants a vaccine has received it.
“For all of us at ChristianaCare who have been serving our community throughout this pandemic, the arrival of the first vaccine is a turning point that we have been waiting for,” said President and CEO Janice E. Nevin, M.D., MPH. “We still have many months ahead before we emerge from the pandemic, but the path forward is becoming clearer.”
Light at the end of the tunnel
“This is the light at the end of the tunnel,” Dr. Nevin said. “We are committed to vaccinating every caregiver who wants to be vaccinated as soon as possible.”
ChristianaCare’s vaccination process began by offering the vaccine first to caregivers who work in direct patient care and roles that support direct patient care, including community physicians who are members of the Medical-Dental Staff, contracted staff and Delaware Branch Campus medical students. Opportunities to get vaccinated were randomized within those groups to ensure a fair, equitable process.
Although the initial supply of vaccine is limited, it is expected to gradually become more available over the coming months, eventually to the general public in spring or summer 2021.
“We are partnering closely with state and federal health agencies and will follow their guidance on administering the vaccine,” said System Chief Operating Officer Sharon Kurfuerst, Ed.D., OTR/L, FACHE.
“We are doing this safely, effectively, with all the documentation and follow-up that is required,” Kurfuerst said. “This is an extraordinary undertaking, but we have an incredible team that is laser-focused on getting the operations and logistics right.”
The arrival of the first vaccines came at a time when COVID-19 cases were spiking across the nation, capping a year in which the virus has taken a terrible toll. Across the United States, as of December 28, 2020, almost 19 million cases of COVID-19 had been reported, resulting in almost 331,000 deaths, according to data from the Centers for Disease Control & Prevention.
“It’s very important for all caregivers to be vaccinated,” said Chief People Officer Neil Jasani M.D., MBA, FACEP. “We cannot require it, but we hope that every caregiver will get it. Getting everyone vaccinated is how we will eliminate COVID-19.”
5 a.m. – Go time
Before dawn on the first day of vaccinations, the vaccine was taken from its subzero freezers at Christiana Hospital and reconstituted in the lab.
Members of the hospital Pharmacy team brought the vaccine down to the first vaccination site, in the John H. Ammon Medical Education Center. Vaccination stations were staged around the perimeter of the auditorium.
It was just 50 minutes from freezer to shoulder.
In the center of the auditorium, chairs were spaced six feet apart in a COVID-safe waiting area where caregivers could be monitored for 15 minutes after their vaccination in case anyone experienced an allergic reaction.
Nurse Practitioner Tabe Mase, MSN, MJ, FNP-C CHC, COHN-S, administered the first vaccination to her colleague Kathleen Bonis. As director of Employee Health, Mase has had a major role in COVID-19 testing for caregivers.
“For me, it’s just humbling. I could not have foreseen this day, how soon it came,” Mase said. “I’m just so happy.”
After being vaccinated, caregivers booked their appointments for their second dose in the two-part Pfizer vaccine, and walked away with an “I got my COVID-19 vaccine” sticker.
Caregivers will continue to wear masks and follow all COVID-19 precautions.
As clinical psychologist Nicole Duffy, Ph.D., got seated for her vaccine, she gently held a photo of her stepfather who died from COVID-19 in April. Through tears, she said, “I feel so grateful and so honored and so humbled.”
At vaccine stations, other caregivers were sighing with relief, smiling with happiness and crying with joy. As they spoke about the vaccine they said:
My shot “is the beginning of the end.”
My shot “is my joy and my life.”
My shot “is doing my part to end the pandemic.”
The caregiver vaccination program is an extraordinary example of ChristianaCare’s values, serving together with love and excellence, Dr. Nevin said.
“Teamwork – serving together – is our number one organizational value,” she said. “Throughout our organization, as we have since the pandemic started, we moved swiftly as one team to establish and implement our caregiver vaccination program.”
ChristianaCare caregivers rose to the occasion as #healthcareheroes, facing extraordinary professional and personal challenges. Working from behind masks, face shields and other essential protective equipment, caregivers were often the only personal contact for critically ill, isolated patients.
“I have found myself acting as a conduit between family and patient, having those most delicate, tragic conversations that occur in the last moments of a patient’s life,” said resident Amber Higgins, M.D.
COVID-19 meant personal sacrifice. For hospitalist Jayaprakash Manda, M.D., COVID-19 has meant “not just a change in a typical work day, but a change in my everyday life.”
“Now, most of my day is emotionally and physically draining, trying to care for patients, while at the same time staying safe and keeping my children safe. Instances where I have craved to play or caress my children were deeply saddening while trying to isolate,” he said.
“Our caregivers have courageously and compassionately fought COVID-19, supporting our patients, one another and our community in innumerable ways, both large and small,” Dr. Nevin said. “Today we begin to come out on the other side, to write a new chapter where we win the battle against COVID-19.”
Time to double down
“The most important message I have for our caregivers and community is this: When it’s your turn, when you have the opportunity, please get vaccinated,” Dr. Nevin said. “I’m looking forward to getting my vaccine when it’s my turn. I’m excited about it and I would encourage everyone to do the same.”
The vaccine is safe and effective, Dr. Nevin said. Although its development happened quickly, it went through all the same kinds of testing and rigorous approval that any vaccine does.
“We recognize that the speed at which the vaccine has been approved has raised questions about its safety,” said Chief Infection Prevention Officer Marci Drees, M.D., MPH. “It’s important to realize that the new technology of mRNA vaccines, like the COVID-19 vaccine, is only available to us now because of nearly two decades of research on mRNA vaccines and on other coronaviruses.”
“We have been following the data and the science throughout the approval process, and we are confident that the approved vaccine is safe and effective,” Dr. Drees said.
The vaccine has been tested with tens of thousands of people who volunteered for large-scale clinical trials, she said.
Ultimately, she said, safety is determined by the Phase 3 trials, which in the case of COVID-19 vaccines were as large as any Phase 3 trials previously conducted for other vaccines.
“These Phase 3 studies were large enough to detect common, uncommon and even some rare side effects,” Dr. Drees said.
The federal emergency use authorization allowed vaccine to be available sooner – after two months of follow-up after the second dose, rather than the customary six months.
“But this was considered reasonable,” Dr. Drees said, “because nearly all vaccine side effects occur within six weeks of vaccination. Much like the flu vaccine, common side effects from the COVID-19 vaccine appear to be mild and the number of serious side effects appears to be very low.
“Even as the vaccine is starting to become available, we still have a long way to go before enough people are vaccinated to achieve “herd immunity,” she said. Herd immunity is when the population (even those who themselves are not yet vaccinated) can be protected from the virus if enough people are vaccinated.
In the meantime, “we’ve got to reduce spread of COVID-19 in our community,” Dr. Drees said.
“I implore our community to follow the measures we know are effective to prevent COVID-10: Wear a mask, wash or sanitize your hands frequently and keep six feet of physical distance from those outside your immediate household,” Dr. Nevin said.
“This is not time to relax. It’s time to double down to stop the spread.”