Front-line health care workers at hospitals and clinics throughout Philadelphia received their first doses of the Pfizer-BioNTech COVID-19 vaccine last week after the Food and Drug Administration granted an emergency use authorization on Dec. 11.
Hannah Leeman, a pandemic planner for the Public Health Preparedness Program for the city’s Department of Public Health, Division of Disease Control, got hers on Dec. 17. She couldn’t be more excited.
“It feels really historic to be part of this,” she said.
Leeman, who is also a resident at Moishe House Philly, is eligible to receive the vaccine because she works at the newly developed citywide clinics providing vaccinations to health care workers who are unaffiliated with hospital systems.
Dr. Steven Sivak, president of Einstein Physicians Philadelphia at Einstein Healthcare Network, leads the network’s COVID-19 task force and is responsible for its vaccine rollout. In the face of limited doses, that means deciding who will get access first.
“We decided a couple of months ago that we were going to try to develop the most ethical approach possible. And what we did was we took into account professional risk and personal risk,” said Sivak, who is Jewish.
Professional risk is based on a recipient’s job. Workers in the emergency room, the intensive care unit or the anesthesiology department have the highest professional risk because they treat patients in an environment where respiratory droplets and aerosols can spread the virus.
Personal risk is based on age and health. If a staff member is over 65 or has an underlying condition, such as diabetes or heart disease, they are also considered high risk and eligible to get the vaccine early.
Dr. Richard Fine, who is also Jewish, faces both professional risk as network chair of the department of anesthesiology at Einstein and personal risk as a survivor of leukemia and melanoma. On the morning of Dec. 16, he got the shot.
“I truly feel privileged to have received it early on,” he said.
Albert Gutmaker, a senior respiratory therapist who has worked at Einstein for more than 47 years, faces personal and professional risk as a front-line worker over 65. He also was vaccinated on Dec. 16.
He said it added new meaning to his Chanukah celebrations this year.
“One day of an injection will lead to many years of life. We can call the Chanukah festival a Festival of Life,” he said.
Sivak said administering Pfizer’s vaccine is a complex process. Unlike a typical flu shot, the COVID-19 vaccine must be chilled at -94 degrees Fahrenheit and thawed before it is reconstituted. Once thawed, health care workers have six hours to administer the vaccine before it goes bad at room temperature.
At Einstein, recipients have to sit for a few minutes after getting the shot so they can be monitored for allergic reactions. They leave the vaccination site with instructions for how to monitor and report side effects.
Fine said staff were notified of the possibility of a low-grade fever, fatigue, aches and chills. If those symptoms did not resolve within the first two days, they would be evaluated in the emergency room.
“We’ve worked hard to differentiate the symptoms of a significant COVID exposure versus a side effect of the vaccine itself. And that’s hugely important because we certainly want to optimize our health care force to return to work,” Fine said.
All staff members who are vaccinated must have their vaccine information entered in an electronic medical record and receive a second dose 21 days later.
Despite these complicated steps, Sivak said the first vaccine session on Dec. 16 went so smoothly the task force decided to add a fifth vaccinator and reduce appointment times from every 15 minutes to every 12 minutes. They will also start vaccinating people six days a week rather than every other day.
Sivak said Einstein hopes to administer the rest of its first doses by Dec. 30, and will receive 1,950 more vaccines to provide second doses. This will be enough to vaccinate almost half of Einstein’s workforce.
Although Fine feels fortunate to be an early recipient of the vaccine, he acknowledged that he felt a bit apprehensive.
“On a personal note, I’m certainly not cavalier about my own health care. And I took the time to email my own oncologist and say, ‘What do you think about this, based upon my medical history?’” he said. “And in capitals, he said, ‘Get the vaccine. The risk of COVID far outweighs the issues with regard to your medical history.’”
Gutmaker felt some soreness at his injection site, but it only lasted for a couple of hours. Leeman experienced some achiness that also passed quickly. Fine feels as though he has gotten any other vaccine. He is, however, anticipating more side effects once he receives his second dose on Jan. 5 based on the studies he has seen.
He looks forward to the relief that day will bring, and the relief more doses will bring to his colleagues, who have been fighting on the front lines of the pandemic for nine long months. His staff face particularly high risk because they are responsible for intubating COVID patients.
“I have a member of my staff that intubated someone to put them on a ventilator that was unfortunately an Einstein employee. The last thing he said to my colleague was, ‘I hope you’re not the last human being that I ever see,’” he said.
Gutmaker, who has lost several friends to coronavirus, said it was important for people to remember that other safety measures have to be taken in addition to the vaccine to stop the spread. Scientists do not yet know whether the vaccine can prevent people from passing the virus on to others, even while the recipients avoid the worst of its effects, so masks and social distancing must continue until more people have immunity.
“The Army, the Navy, the Air Force, Marines, they all work together in a war to win. Well, you have Pfizer, Moderna, two other vaccine developers. You’ve got masks. You’ve got disinfecting agents and all that. They’re all the military forces we have available to beat this thing. And we can do it, but it’s a matter of cooperation, coordination and caring, more than anything else, caring about other people and yourself,” he said.